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Number | Document Name | Effective Date |
---|---|---|
FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
FAA-1494A-SLP | Remoción de un(a) Representante Autorizado(a) (Letra Grande) | 05/01/2023 |
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-1701A-LP | Verification of Terminated Employment - Large Print (English) | 05/01/2023 |
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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