You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0412A-XLP | Change Report - Extra Large Print (English) | 05/01/2023 |
|
FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
|
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
|
FAA-1004A-S | Designation of EBT Alternate Card Holder (Spanish) | 05/01/2023 |
|
FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
|
FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 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-0620A | Treatment Center Change Report | 05/01/2023 |
|
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
|
FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
|
FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
|
FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
|
FAA-1701A-XLP | Verification of Terminated Employment - Extra Large Print (English) | 05/01/2022 |
|
FAA-1442A | Tribal-Authority to Release Information / Autoridad Tribal para Divulgar Información | 12/01/2019 |
|
FAA-0075A | Verification of School Attendance (English) | 12/01/2019 |
|
AH-800 | AHCCCS Information for Applicants | 11/01/2018 |
|
AH-800-S | ¿Qué Servicios Cubre el Seguro de Salud de AHCCCS? | 11/01/2018 |
|
FA-065-FFS | Verificación de Arreglos de Vivienda/Dirección Residencial | 07/01/2017 |
Stay up-to-date with news and updates delivered straight to your inbox
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