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Number | Document Name | Effective Date |
---|---|---|
FAA-1439A-SLP | Self-Employment Income Statement - Large Print (Spanish) | 06/01/2023 |
FAA-0059A | Authority to Release Records | 06/01/2023 |
FAA-1439A-S | Self-Employment Income Statement (Spanish) | 06/01/2023 |
FAA-0059A-S | Autoridad para Divulgar Expedientes | 06/01/2023 |
FAA-1111A-SXLP | Formulario para Verificar la Declaración del Participante (Letra extra grande) | 06/01/2023 |
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-1111A-S | Formulario para Verificar la Declaración del Participante | 06/01/2023 |
FAA-0177A | Claim of Good Cause (Eng/Span) | 06/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
FAA-1494A | Authorized Representative Removal | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 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 |
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-1494A-SXLP | Remoción de un(a) Representante Autorizado(a) (Letra Extra Grande) | 05/01/2023 |
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