You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
FAA-1701A-LP | Verification of Terminated Employment - Large Print (English) | 05/01/2023 |
DDD-1622A | Home Modification Requests Support Coordinator’s (SC) Checklist (English) | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
CCA-1261A | Certified Family Child Care Provider Application | 07/01/2019 |
RSA-1312A | Authorization for Disclosure of Health Information to RSA | 07/01/2019 |
RSA-1312A-S | Autorización Para Divulgación De Información De Salud a RSA | 07/01/2019 |
UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
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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