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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
| GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
| FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
| FAA-1249A | Verification of Disability | 05/01/2023 |
| CCA-0221A | Family Child Care Provider Statement of Services (English) | 05/01/2023 |
| FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
| FAA-0574A-SXLP | Withdrawal or Stop Benefits/Appeal Request - Extra Large Print (Spanish) | 05/01/2023 |
| CSE-1061A | Establishing Paternity (English) | 05/01/2023 |
| FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 05/01/2023 |
| DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| CSE-1007 | Customer Satisfaction Survey | 09/01/2019 |
| DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
| DDD-1532A-S | Hardship Reduction Request (Spanish) | 09/01/2019 |
| UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
| RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
| DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
| DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
| DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
| UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
| CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
Arizona State Resources
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
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