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-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
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CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
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FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
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FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
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FAA-0053A-LP | Verification of New/Current Employment - Large Print (English) | 05/01/2023 |
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FAA-1506A | Statement of No Income (English) | 05/01/2023 |
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FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
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FAA-0255A | Separate Household Status Statement | 05/01/2023 |
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CCA-1163A-S | Afidávit de Exención de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores | 05/01/2023 |
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FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-2149A | Authorization to Release Records | 08/01/2022 |
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FAA-1828A | Provider Determination | 08/01/2022 |
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GCI-1147B | Records Request Response (Contractors) | 08/01/2022 |
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FAA-1570A | Cash Assistance Drug Conviction Sanction Agreement | 08/01/2022 |
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CCA-0231A-2022 | Child Care Assistance Unwed Minor Parent Deeming Worksheet | 07/01/2022 |
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HRP-1001A | USDA Commodity Loss Report (CLR) | 07/01/2022 |
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HRP-1005A | TEFAP Monthly Inventory and Participation Report (MIPR) | 07/01/2022 |
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HRP-1016A-S | Confidencialidad del Voluntario | 07/01/2022 |
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CS-127-PF | Acknowledgment of Paternity (English / Spanish) | 07/01/2022 |
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HRP-1039A | Commodity Senior Food Program (CSFP) Participant Rights and Obligations | 07/01/2022 |
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