You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0412A-SLP | Change Report - Large Print (Spanish) | 05/01/2023 |
|
CCA-0221A | Family Child Care Provider Statement of Services | 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-0259A-S | Denuncia de Abuso o Negligencia de un Padre Soltero que es Menor de Edad | 05/01/2023 |
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CSE-1061A | Establishing Paternity | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
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GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
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FAA-0412A-S | Change Report (Spanish) | 05/01/2023 |
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CCA-0221A-S | Declaración de Servicios del Proveedor de Cuidado en Casa de Familia | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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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-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
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DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
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CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/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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