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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-1021A | Unpaid Co-payment Worksheet (English) | 10/01/2022 |
| CCA-1021A-S | Unpaid Co-payment Worksheet (Spanish) | 10/01/2022 |
| CCA-0048A | Non-Certified Relative Provider Billing Report | 10/01/2022 |
| CCA-0048A-S | Informe de Facturación de Proveedores Parientes no Certificados | 10/01/2022 |
| CCA-0031A | Verbal Notice of Eligibility (English/Spanish) | 10/01/2022 |
| CC-214-A | Relative Child Care Provider Rate Agreement | 11/01/2022 |
| CC-214-A-S | Acuerdo de Tarifa para Parientes Proveedores de Cuidado de Niños | 11/01/2022 |
| CC-214 | Child Care Provider Rate Agreement | 11/01/2022 |
| CC-214-S | Acuerdo de Tarifas del Proveedor de Cuidado de Niños | 11/01/2022 |
| CCA-1200A-S | About Me Questionnaire (Spanish) | 11/01/2022 |
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-0039A | Medical Statement (English) | 12/01/2022 |
| CCA-0039A-S | Medical Statement (Spanish) | 12/01/2022 |
| CCA-1312A | Provider/Parent/Guardian's Agreement for Non-DES Child Care Charges | 03/01/2023 |
| CCA-1312A-S | Acuerdo del Proveedor/Padre/Madre/Tutor Acerca de los Costos de Cuidado de Niños No Cubiertos por el DES | 03/01/2023 |
| CCA-1175A | Landlord Permission to Provide Family Child Care Service (English) | 04/01/2023 |
| CCA-1175A-S | Landlord Permission to Provide Family Child Care Service (Spanish) | 04/01/2023 |
| CCA-0221A | Family Child Care Provider Statement of Services | 05/01/2023 |
| CCA-0221A-S | Declaración de Servicios del Proveedor de Cuidado en Casa de Familia | 05/01/2023 |
| CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
| CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
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Arizona State Resources
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
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