You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
FAA-1765A | Authority to Release Information | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
FAA-1494A | Authorized Representative Removal (English) | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (English) | 07/01/2019 |
LCR-1007A-S | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (Spanish) | 07/01/2019 |
CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
GCI-1049A | No Contact Letter | 07/01/2019 |
CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
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