You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
FAA-1353A-S | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance (Spanish) | 05/01/2023 |
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 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 |
GCI-1113A | Child Transfer Form | 10/01/2019 |
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
RSA-1384A | BEP Job-Shadowing Evaluation | 09/01/2019 |
CSE-1007A-S | Encuesta de Satisfacción del Cliente | 09/01/2019 |
CSE-1007 | Customer Satisfaction Survey | 09/01/2019 |
DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
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