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Number | Document Name | Effective Date |
---|---|---|
FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
FAA-1546A | Sponsor Deeming Information (English) | 05/01/2023 |
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
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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