You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1765A | Authority to Release Information | 05/01/2023 |
FAA-1768A-S | Overpayment Compromise Request Form (Spanish) | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request - Extra Large Print (English) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
GCI-1033A | Transition Conference Summary | 05/01/2023 |
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UB-217 | Wage / Employment Investigation Request (English) | 01/01/2020 |
FCT-1000A | Formal Request for Tribal Community | 01/01/2020 |
UB-217C | Wage Protest (English) | 01/01/2020 |
FAA-0075A | Verification of School Attendance (English) | 12/01/2019 |
FAA-1442A | Tribal-Authority to Release Information / Autoridad Tribal para Divulgar Información | 12/01/2019 |
CCA-0218A-S | Sign-In/Sign-Out Record (Spanish) | 10/01/2019 |
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
LCR-1034A-S | Criminal History Self Disclosure Affidavit (Spanish) | 10/01/2019 |
GCI-1113A | Child Transfer Form | 10/01/2019 |
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
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