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-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
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FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
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FAA-0060A | Authority to Release Student Information (English) | 05/01/2023 |
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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 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-0065A | Verification of Living Arrangements/Residential Address (English) | 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 |
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GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2107A | What Works and What Doesn't Work Worksheet | 06/01/2021 |
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UIB-0126A | Request for Reconsideration/Appeal (English) | 06/01/2021 |
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DDD-2106A | Member's Circles of Support | 06/01/2021 |
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DDD-2107A-S | Hoja de Trabajo Sobre lo que Funciona y lo que no Funciona | 06/01/2021 |
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AAA-1350C | Annual Follow Up | 05/01/2021 |
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CCA-1287A | Emergency Evacuation Drill Record | 05/01/2021 |
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CCA-1287A-S | Registro de Simulacros de Evacuación de Emergencia | 05/01/2021 |
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DDD-1530A | Managed Risk Agreement Services and/or Placement (English) | 05/01/2021 |
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DDD-1530A-LP | Managed Risk Agreement Services and/or Placement (Large Print) | 05/01/2021 |
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DDD-1530A-S | Managed Risk Agreement Services and/or Placement (Spanish) | 05/01/2021 |
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