You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
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FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
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FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
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FAA-0620A | Treatment Center Change Report | 05/01/2023 |
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FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
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FAA-1506A | Statement of No Income (English) | 05/01/2023 |
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FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
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FAA-1546A-S | Información de Determinar a un Patrocinador | 05/01/2023 |
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FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
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FAA-0412A-SXLP | Change Report - Extra Large Print (Spanish) | 05/01/2023 |
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CCA-1163A-S | Afidávit de Exención de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
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DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
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DDD-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
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CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
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DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
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CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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DDD-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
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DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
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CSE-1168A | Agreement to Accept Service by Mail - TANF Workshops | 09/01/2021 |
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DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
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