Arizona Department of Economic Security
Your Partner for a Stronger Arizona

AZ At Work Logo

Main menu

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

  1. 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. 
  2. 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. 
  3. You can click on the column headers to sort the search results.

Download Number Name Effective Date
CCA-1163AS Affidávit de Exendión de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores 09/01/2011
CCA-1164A Affidavit of Immunization Exemption - For Children in Care 09/01/2011
CCA-1164AS Affidávit de Exención de Vacunación - Para Menores Bajo Cuidado 09/01/2011
CC-221-FF Family Child Care Provider Statement of Services 09/01/2011
CC-221-FFS Declaración de Servicios del Proveedor de Cuidado en Casa de Familia 09/01/2011
CC-005-FF Log of Accidents, Injuries or Illnesses (Eng/Span) 09/01/2011
CC-208-S Acuerdo del Proveedor/Padre/Madre/Guardian - Acerca de los Costos de Cuidado de Niños 05/01/2011
CC-208 Provider/Parent/Guardian's Agreement for Child Care Charges 05/01/2011
CCA-1095A State of AZ Substitute W-9 form-Request for Taxpayer Identification and Certification 04/01/2004
CCA-1095AS State of AZ Substitute W-9 form-Request for Taxpayer Identification and Certification (Spanish) 04/01/2004

Download Number Name Effective Date
Statistical Bulletin July 2019 Statistical Bulletin July 2019 08/23/2019
EEO Utilization Report Equal Employment Opportunity Utilization Report 08/16/2019
30th Month Mar 2019 30th Month Financial Report FY 2019 through Mar 2019 07/26/2019
30th Month Apr 2019 30th Month Financial Report FY 2019 through Apr 2019 07/26/2019
30th Month May 2019 30th Month Financial Report FY 2019 through May 2019 07/26/2019
Statistical Bulletin June 2019 Statistical Bulletin June 2019 07/15/2019
SSBG Plan 2019-2020 Social Services Block Grant Plan 2019-2020 07/01/2019
6AAC2 Five-Year Review Report - Employment and Training 06/28/2019
6AAC5-Article-52 Five-Year Review Report - Child Care Assistance 06/28/2019
Statistical Bulletin May 2019 Statistical Bulletin May 2019 06/14/2019

No results available.

Download Number Name Effective Date
HRP-1047A-S Programa Suplementario de Comestibles Básicos (CSFP) de Arizona 05/01/2020
DES-1198A Human Services Campus 05/01/2020
HRP-1047A Arizona Commodity Senior Food Program (CSFP) 05/01/2020
FAA-1775A How Do I File a Complaint (English/Spanish) 04/01/2020
GCI-1117A-S AZEIP está aceptando referencias durante la crisis COVID-19 04/01/2020
GCI-1117A AZEIP is accepting Referrals during COVID-19 Crisis 04/01/2020
ESA-1353A Federal Bonding Program 03/01/2020
CSE-1246B Child Support Services Program Overview (Bilingual) 02/01/2020
LCR-1036A Life-Safety Inspections 02/01/2020
RSA-1134A What Is Voc Rehabilitation? 02/01/2020


No results available.


Download Number Name Effective Date
CCA-1176A Parent/Guardian Affidavit of Non-Compensated Child Care 02/01/2013
CCA-1176AS Declaración Jurada del Padre o Tutor por Cuidado de Niños no Remunerado 02/01/2013
CC-036-FF Permission to Give Medication 12/01/2012
CC-036-FFS Permiso para Administrar Medicamentos 12/01/2012
CC-004-FF Accident, Illness or Injury Report (Eng/Span) 09/01/2012
CCA-1170A Withdrawal or Termination Request for Child Care Providers 08/01/2012
CCA-1170AS Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños 08/01/2012
CCA-1021A Unpaid Co-payment Worksheet 11/01/2011
CCA-1021S Informe de Copagos Atrasados 11/01/2011
CCA-1163A Affidavit of Immunization Exemption - For Household Members Age 13 and Younger 09/01/2011

Back to Top