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-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
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FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
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CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
|
FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
|
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
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FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-1506A | Statement of No Income (English) | 05/01/2023 |
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FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
|
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
|
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1287A-S | Registro de Simulacros de Evacuación de Emergencia | 05/01/2021 |
|
UIA-1069A | Application for Mixed Earners Unemployment Compensation | 04/01/2021 |
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UIA-1069A-S | Solicitud de Compensación por Desempleo de Asalariados Mixtos | 04/01/2021 |
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CCA-1211B | Attachment to Request for Search of Background Checks (CCA-1211A) Disqualifying Acts (English) | 04/01/2021 |
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CCA-1211B-S | Attachment to Request for Search of Background Checks (CCA-1211A-S) Disqualifying Acts (Spanish) | 04/01/2021 |
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CCA-1234A | Family Child Care Home Backup Provider Backup, Discipline, and Transportation Agreement | 04/01/2021 |
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CCA-1234A-S | Proveedor Suplente de Cuidado de Niños en el Hogar Acuerdo de Suplente, Disciplina y Transporte | 04/01/2021 |
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DDD-1436A | Behavioral Health Professional Consultation Summary (English) | 04/01/2021 |
|
ESA-1338A | Language Line Translation Services Utilized | 03/01/2021 |
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DDD-1530A-SLP | Managed Risk Agreement Services and/or Placement -Large Print (Spanish) | 03/01/2021 |
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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