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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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
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FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
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FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
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FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
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FAA-1765A | Authority to Release Information | 05/01/2023 |
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FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 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-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
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FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1570A-S | Acuerdo de Sanción de Asistencia en efectivo (CA) por condena de drogas | 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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FAA-1570A | Cash Assistance Drug Conviction Sanction Agreement | 08/01/2022 |
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HRP-1005A | TEFAP Monthly Inventory and Participation Report (MIPR) | 07/01/2022 |
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UIB-0101C-S | Declaración Jurada del Plan de Búsqueda de Trabajo | 07/01/2022 |
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CCA-0231A-2022 | Child Care Assistance Unwed Minor Parent Deeming Worksheet | 07/01/2022 |
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HRP-1039A | Commodity Senior Food Program (CSFP) Participant Rights and Obligations | 07/01/2022 |
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HRP-1015A | Annual Civil Rights Training (English) | 07/01/2022 |
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UIB-0101C | Work Search Plan of Action Affidavit (English) | 07/01/2022 |
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