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Number | Document Name | Effective Date |
---|---|---|
FAA-1111A-SXLP | Formulario para Verificar la Declaración del Participante (Letra extra grande) | 06/01/2023 |
FAA-1111A-XLP | Participant Statement Verification Worksheet (Extra Large Print) | 06/01/2023 |
FAA-1145A | Authorization to Share Information (English/Spanish) | 07/01/2023 |
FAA-1148A | Medical Incapacity Statement (Hospitalized Applicant) | 07/01/2023 |
FAA-1182A | AHCCCS Fraud Prevention Determination Authorization | 07/01/2023 |
FAA-1208A | Language Notification Flyer | 01/01/2021 |
FAA-1208A-LP | Language Notification Flyer (Large Print) | 02/01/2021 |
FAA-1208A-XLP | Language Notification Flyer (Extra Large Print) | 03/01/2021 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1182A | AHCCCS Fraud Prevention Determination Authorization | 07/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
FAA-1410A | Grant Diversion Script and Applicant Agreement | 07/01/2023 |
FAA-1410A-LP | Grant Diversion Script and Applicant Agreement (Large Print) | 07/01/2023 |
FAA-1410A-S | Acuerdo de Solicitante y Guión de Desvío de Subvención | 07/01/2023 |
FAA-1410A-SLP | Acuerdo de Solicitante y Guión de Desvío de Subvención (Letra Grande) | 07/01/2023 |
FAA-1410A-SXLP | Acuerdo de Solicitante y Guión de Desvío de Subvención (Letra Extra Grande) | 07/01/2023 |
FAA-1410A-XLP | Grant Diversion Script and Applicant Agreement (Extra Large Print) | 07/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
30th Month December 2020 | 30th Month Financial Report FY 2021 through December 2020 | 03/26/2021 |
30th Month December 2021 | 30th Month Financial Report FY 2022 through December 2021 | 01/31/2022 |
30th Month December 2022 | 30th Month Financial Report FY 2023 through December 2022 | 01/31/2023 |
30th Month December 2023 | 30th Month Financial Report FY 2024 through December 2023 | 02/02/2024 |
30th Month Feb 2019 | 30th Month Financial Report FY 2019 through Feb 2019 | 05/13/2019 |
30th Month Feb-2015 | 30th Month Report February Fiscal Year 2015 | 04/29/2015 |
30th Month Feb-2016 | 30th Month Report February Fiscal Year 2016 | 04/11/2016 |
30th Month Feb-2017 | 30th Month Report February Fiscal Year 2017 | 04/18/2017 |
30th Month Feb-2018 | 30th Month Financial Report FY-2018 through Feb-2018 | 03/30/2018 |
30th Month February 2014 | 30th Month Report February Fiscal Year 2014 | 04/02/2014 |
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