You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
|
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
|
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
|
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
|
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
|
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
|
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
|
FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 05/01/2023 |
|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
|
FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
|
DDD-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
|
DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
|
DDD-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
|
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
|
CSE-1168A | Agreement to Accept Service by Mail - TANF Workshops | 09/01/2021 |
|
DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
|
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
|
DDD-2098A | Hourly Nursing Assessment Tool (H-NAT) | 09/01/2021 |
|
CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
Stay up-to-date with news and updates delivered straight to your inbox
Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification