You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
FAA-1565A | Nutrition Assistance Drug Testing Agreement (English) | 05/01/2023 |
FAA-1725A | Verification of Other Income | 05/01/2023 |
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UB-217 | Wage / Employment Investigation Request (English) | 01/01/2020 |
UB-217C | Wage Protest (English) | 01/01/2020 |
FAA-1442A | Tribal-Authority to Release Information / Autoridad Tribal para Divulgar Información | 12/01/2019 |
FAA-0075A | Verification of School Attendance (English) | 12/01/2019 |
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 10/01/2019 |
LCR-1034A-S | Criminal History Self Disclosure Affidavit (Spanish) | 10/01/2019 |
CCA-0218B-S | Registro de Entradas y Salidas (Versión extendida) | 10/01/2019 |
CCA-0218A-S | Sign-In/Sign-Out Record (Spanish) | 10/01/2019 |
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
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