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Number | Document Name | Effective Date |
---|---|---|
FAA-1111A-SLP | Formulario para Verificar la Declaración del Participante (Letra grande) | 06/01/2023 |
FAA-1111A | Participant Statement Verification Worksheet | 06/01/2023 |
FAA-0177A | Claim of Good Cause (English/Spanish) | 06/01/2023 |
FAA-1111A-S | Formulario para Verificar la Declaración del Participante | 06/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request - Extra Large Print (English) | 05/01/2023 |
FAA-0574A-SXLP | Withdrawal or Stop Benefits/Appeal Request - Extra Large Print (Spanish) | 05/01/2023 |
FAA-0257A | Individual Development Account Agreement (English) | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
FAA-1494A-SXLP | Authorized Representative Removal - Extra Large Print (Spanish) | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
FAA-1494A-SLP | Authorized Representative Removal - Large Print (Spanish) | 05/01/2023 |
FAA-1494A-LP | Authorized Representative Removal - Large Print (English) | 05/01/2023 |
FAA-1494A-S | Authorized Representative Removal (Spanish) | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-1546A | Sponsor Deeming Information (English) | 05/01/2023 |
FAA-0257A | Individual Development Account Agreement (English) | 05/01/2023 |
FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
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