You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1701A-LP | Verification of Terminated Employment - Large Print (English) | 05/01/2023 |
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request - Large Print (English) | 05/01/2023 |
FAA-0574A-SLP | Withdrawal or Stop Benefits/Appeal Request - Large Print (Spanish) | 05/01/2023 |
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
FAA-1494A | Authorized Representative Removal (English) | 05/01/2023 |
FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 05/01/2023 |
FAA-1768A | Overpayment Compromise Request Form (English) | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request (English) | 05/01/2023 |
FAA-1768A-S | Overpayment Compromise Request Form (Spanish) | 05/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
FAA-1768A | Overpayment Compromise Request Form (English) | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 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 |
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