You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1208A-LP | Language Notification Flyer (Large Print) | 02/01/2021 |
FAA-1208A-XLP | Language Notification Flyer (Extra Large Print) | 03/01/2021 |
FAA-1701A-XLP | Verification of Terminated Employment - Extra Large Print (English) | 05/01/2022 |
FAA-1828A | Provider Determination (English) | 08/01/2022 |
FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-1494A | Authorized Representative Removal | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 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