You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
FAA-1494A | Authorized Representative Removal | 05/01/2023 |
FAA-1565A-S | Acuerdo de Prueba de Drogas para recibir Asistencia Nutricional | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FCT-1000A | Formal Request for Tribal Community | 01/01/2020 |
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-S | Sign-In/Sign-Out Record (Spanish) | 10/01/2019 |
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
GCI-1113A | Child Transfer Form | 10/01/2019 |
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 10/01/2019 |
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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