You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
CCA-0221A-S | Declaración de Servicios del Proveedor de Cuidado en Casa de Familia | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
RSA-1386A | BEP 8 Step Process | 09/01/2019 |
DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights | 07/01/2019 |
LCR-1007A-S | Informe de Visita al Hogar Suplemento Al Aviso de Derechos De Inspección y Debido Proceso | 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