You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
FAA-1494A | Authorized Representative Removal | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UB-217C | Wage Protest (English) | 01/01/2020 |
UB-217 | Wage / Employment Investigation Request (English) | 01/01/2020 |
FCT-1000A | Formal Request for Tribal Community | 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-S | Criminal History Self Disclosure Affidavit (Spanish) | 10/01/2019 |
GCI-1113A | Child Transfer Form | 10/01/2019 |
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
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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