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-1768A | Overpayment Compromise Request Form | 05/01/2023 |
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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
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FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
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FAA-1765A | Authority to Release Information | 05/01/2023 |
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FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
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FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
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FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
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FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
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AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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FAA-1570A | Cash Assistance Drug Conviction Sanction Agreement | 08/01/2022 |
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HRP-1032A-S | Programa Suplementario de Comestibles Básicos (CSFP) Solicitud para Reunión Informal de Resolución de Disputas / Audiencia Imparcial | 08/01/2022 |
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FAA-1570A-S | Acuerdo de Sanción de Asistencia en efectivo (CA) por condena de drogas | 08/01/2022 |
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HRP-1052A | CSFP Notice of Action | 08/01/2022 |
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RSA-1382A | BEP Memo | 08/01/2022 |
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HRP-1052A-S | Aviso de Acción del Programa Suplementario de Comestibles Básicos (CSFP) | 08/01/2022 |
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HRP-1041A-S | Programa Suplementario de Comestibles Básicos (CSFP) Aviso de Inscripción en la Lista de Espera | 08/01/2022 |
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DDD-2149A | Authorization to Release Records | 08/01/2022 |
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FAA-1828A | Provider Determination | 08/01/2022 |
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HRP-1028A | Application for Benefits (TEFAP, CSFP) | 08/01/2022 |
Download | Number | Name | Effective Date |
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DIR-1022C | DES on the GO | 01/01/2017 |
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OBM-1000A | The Office of the Ombudsman | 01/01/2017 |
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DIR-1022C-S | DES en Movimiento | 01/01/2017 |
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OBM-1000A-S | La Oficina de Defensor de Cliente | 01/01/2017 |
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DDD-1795APAMS | Cuidado Dental Adulto (Edad 21+) | 12/01/2016 |
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DDD-1795APAMPD | Dental Care Adult (Ages 21+) | 12/01/2016 |
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DDD-1751A | Responsible Driving Information Fact Sheet#6 (English) | 07/01/2016 |
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DDD-1748B | Strategic Plan 2016-2020 Overview | 07/01/2016 |
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DDD-1748A | Strategic Plan 2016 - 2020 | 06/01/2016 |
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DDD-1748B-S | Plan Estratégico 2016-2020 Resumen | 06/01/2016 |
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