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Number | Document Name | Effective Date |
---|---|---|
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 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-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
FAA-1546A-S | Sponsor Deeming Information (Spanish) | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1494A-XLP | Authorized Representative Removal - Extra Large Print (English) | 05/01/2023 |
FAA-1768A-S | Overpayment Compromise Request Form (Spanish) | 05/01/2023 |
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-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
FAA-0574A-SXLP | Withdrawal or Stop Benefits/Appeal Request - Extra Large Print (Spanish) | 05/01/2023 |
FAA-1494A | Authorized Representative Removal (English) | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request (English) | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 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