You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 05/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
FAA-1565A-S | Nutrition Assistance Drug Testing Agreement (Spanish) | 05/01/2023 |
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
CCA-1260A | Back Up Provider Application | 07/01/2019 |
CCA-1261A | Certified Family Child Care Provider Application | 07/01/2019 |
UB-099-Y | Certification of Understanding (English / Spanish) | 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