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Reports, Forms, Pamphlets and Policies

You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services. 

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  1. Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down. 
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Download Number Name Effective Date
FAA-1701A Verification of Terminated Employment 05/01/2023
FAA-1725A-S Verificación de Otros Ingresos 05/01/2023
​FAA-0412A-LP ​Change Report - Large Print (English) 05/01/2023
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-0412A ​Change Report (English) 05/01/2023
FAA-1768A Overpayment Compromise Request Form 05/01/2023
FAA-1249A-XLP Verification of Disability (Extra Large Print) 05/01/2023
FAA-0574A-SXLP Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) 05/01/2023
FAA-1506A Statement of No Income 05/01/2023

Download Number Name Effective Date
FAA-1768A-S Formulario de Solicitud de Reducción de Pago en Exceso 05/01/2023
FAA-0574A Withdrawal or Stop Benefits/Appeal Request 05/01/2023
FAA-1725A-S Verificación de Otros Ingresos 05/01/2023
​FAA-0412A-LP ​Change Report - Large Print (English) 05/01/2023
FAA-0620A Treatment Center Change Report 05/01/2023
FAA-0098A-S Solicitud de Apelación 05/01/2023
FAA-1701A Verification of Terminated Employment 05/01/2023
FAA-1004A-LP Designation of EBT Alternate Card Holder - Large Print (English) 04/01/2023
CCA-1312A Provider/Parent/Guardian's Agreement for Non-DES Child Care Charges 03/01/2023
FAA-0001U Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 02/01/2023

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