You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number |
Name |
Effective Date |
---|---|---|---|
|
FAA-1847A-S | Electronic Benefit Theft Replacement Request Form (Spanish) | 10/01/2023 |
|
FAA-1847A-XLP | Electronic Benefit Theft Replacement Request Form - Extra Large Print (English) | 10/01/2023 |
|
FAA-1847A-SXLP | Electronic Benefit Theft Replacement Request Form - Extra Large Print (Spanish) | 10/01/2023 |
|
FAA-1847A-LP | Electronic Benefit Theft Replacement Request Form - Large Print (English) | 10/01/2023 |
|
FAA-1847A-SLP | Electronic Benefit Theft Replacement Request Form - Large Print (Spanish) | 10/01/2023 |
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
|
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
|
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
UIT-0603A (FY18-23) | Unemployment Insurance Tax Rates for Previous Years (English) | 12/01/2023 |
|
UC-018 | Unemployment Tax Wage Report (English) | 01/01/2023 |
|
DDD-1725A | Uniform Billing Document (Short form) | 12/17/2008 |
|
CCA-1021A | Unpaid Co-payment Worksheet | 10/01/2022 |
|
FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
|
HRP-1014A | USDA Civil Rights Complaint and Grievance | 02/01/2022 |
|
HRP-1001A | USDA Commodity Loss Report (CLR) | 07/01/2022 |
|
HRP-1027A | USDA Compliance Review | 09/01/2023 |
|
RSA-BP1532 | Vending Log Blank | 06/07/2015 |
|
CCA-0031A | Verbal Notice of Eligibility (English/Spanish) | 10/01/2022 |
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