You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
|
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
|
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
|
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
|
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
|
DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
|
FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
|
CCA-1163A-S | Afidávit de Exención de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores | 05/01/2023 |
|
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
|
DDD-2092A | DDD Behavioral Health Advocacy Plan | 03/01/2021 |
|
DDD-2092A-S | Plan de Defensa de la Salud Conductual de la DDD | 03/01/2021 |
|
UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
|
RSA-1298A | Referral Form (English) | 02/01/2021 |
|
FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
|
UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
|
RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
|
RSA-1396A | Secure Email Waiver | 02/01/2021 |
|
LCR-1087A | Child Developmental Certified Home Application Cover Page | 02/01/2021 |
Stay up-to-date with news and updates delivered straight to your inbox
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