UPDATE: PUA claimants who were not able to certify for eligible weeks prior to April 19 are now able to file for eligible weeks back to their last date of employment (but no earlier than February 2). Individuals must file weekly PUA certifications for each week for which they are claiming eligibility for benefits, including retroactive certifications back to their last date of employment. Individuals who have already received the initial phase of payment will not see the option to certify for the three weeks for which they have already been paid. File weekly certifications at https://pua.azdes.gov.
UPDATE: Pandemic Emergency Unemployment Compensation (PEUC), which provides an extension of unemployment benefits, will be available in Arizona June 6.
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| Download | Number | Form Name | Effective Date |
|---|---|---|---|
|
GCI-1109A | Consent to Share Early Intervention Referral and Initial IFSP Date | 06/01/2018 |
|
GCI-1101A | Reversal/Void Invoice Linte Item Request | 10/01/2016 |
|
GCI-1043A-S | Developmental Evaluation Report (Spanish Accessible) | 06/01/2016 |
|
GCI-1043A | Developmental Evaluation Report (Accessible) | 06/01/2016 |
|
GCI-1050B | Prior Written Notice (Accessible) | 04/01/2016 |
|
GCI-1050BS | Notificación Previa Por Escrito (Accessible) | 04/01/2016 |
|
GCI-1088BS | Guía de Evaluación para los Niños y sus Familias (Accessible) | 04/01/2016 |
|
GCI-1088B | Child and Family Assessment Guide for Families (Accessible) | 04/01/2016 |
|
GCI-1088A | Child and Family Assessment Guide for Families | 04/01/2016 |
|
GCI-1103A | AZEIP Waiver Request | 11/01/2015 |
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