You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name |
Effective Date |
---|---|---|---|
|
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
|
FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
|
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
|
FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
|
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
|
FAA-0053A-LP | Verification of New/Current Employment - Large Print (English) | 05/01/2023 |
|
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
|
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
|
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DES-1232A | Arizona Voter Registration Form (Bilingual) | 09/01/2022 |
|
RSA-1213A-SLP | Autorización para Divulgación de Información de Salud a RSA (Letra Grande) | 09/01/2022 |
|
RSA-1365A-LP | Authorization/Consent for Disclosure and Use of Confidential Information Between DDD And RSA (Large Print) | 09/01/2022 |
|
ETA-83 | Weekly Request for Assistance | 09/01/2022 |
|
DDD-1734A | Individually Designed Living Arrangement (IDLA) Assurances (English) | 09/01/2022 |
|
RSA-1365A-SLP | Autorización/Consentimiento para Divulgación y Uso de Información Confidencial entre DDD y RSA (Letra Grande) | 09/01/2022 |
|
GCI-1096A | Individual Family Teaming Report | 09/01/2022 |
|
ETA-083-S | Solicitud Semanal de Asistencia | 09/01/2022 |
|
DDD-1734A-S | Individually Designed Living Arrangement (IDLA) Assurances (Spanish) | 09/01/2022 |
|
ETA-081 | Initial Application for Disaster Unemployment Assistance | 09/01/2022 |
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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