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Download Number Form Name Effective Date
FA-161 Tribal Native Employment Works (New) Referral 09/01/2018
UB-105 Arizona Initial Claim for Unemployment Insurance 09/01/2018
UB-105-S Reclamo Inicial para Seguro por Desempleo en Arizona 09/01/2018
J-020-LP Client Discrimination Complaint (Large Print) 09/01/2018
FAA-1217A Request for Verification of Godparent Specified Relative 09/01/2018
FAA-1402A San Carlos Apache Tribe TANF Referral Notice 09/01/2018
DD-191 Incident Report 09/01/2018
SNA-1000A Rights and Responsibilities 09/01/2018
DES-1077A-S Aviso Sobre Las Prácticas de Confidencialidad 09/01/2018
DES-1059A Authorization to Release Information 09/01/2018

Download Number Form Name Effective Date
30th Month Nov-2014 30th Month Report November Fiscal Year 2014 01/28/2014
2013 Homeless Lottery Funds Report 2013 Homeless Lottery Funds Report 12/30/2013
Annual Report on Homelessness 2013 22nd Annual Report on Homelessness December 2013 12/30/2013
Five Year Strategic Plan SFY 2015 - 2019 Five Year Strategic Plan SFY 2015 - 2019 12/20/2013
30th Month Oct-2014 30th Month Report October Fiscal Year 2014 12/19/2013
Statistical Bulletin November 2013 Statistical Bulletin November 2013 12/13/2013
Rehabilitation Council Annual Report 2013 Governor's State Rehabilitation Council 2013 Annual Report 12/01/2013
30th Month Sep-2014 30th Month Report September Fiscal Year 2014 11/15/2013
Statistical Bulletin October 2013 Statistical Bulletin October 2013 11/14/2013
IDEA Part C Exiting FFY 2013 Exiting 2012-13 11/06/2013

No results available.

Download Number Form Name Effective Date
CCA-1182AS Proveedores de Cuidado de Niños en casa, certificados por el DES 09/01/2013
PAD-195 Statement of Rights 08/01/2013
PAD-195-S Declaración de Derechos 08/01/2013
GCI-1070A Child and Family Rights in the Arizona Early Intervention Program 07/01/2013
GCI-1070A-S Derechos del Menor y la Familia bajo en Programa de Intervención Temprana de Arizona (AzEIP) 07/01/2013
RSA-PL8243 Client Assistance Program 06/20/2013
PAY-626 Non-Certified Relative Child Care Provider Program 04/01/2013
PAY-626-S Programa de Parientes como Proveedores No Certificados de Cuidado de Niños 04/01/2013
GCI-1081A-S La Importancia de la Historia Familiar 01/01/2013
FA-177-FF Claim of Good Cause (Eng/Span) 12/01/2012


Download Number Form Name Effective Date
FAA-1365A Definition of Terms 04/01/2019
DDD-1472D-S Paquete del Repaso Anual y Actualización del ISP (Enfocado/ Sólo para DD - 3 años y más de edad) 04/01/2019
RSA-1298A-LP Referral Form (Large Print) 04/01/2019
FAA-1366A Eligibility Requirements 04/01/2019
DDD-0254A Fire Risk profile 04/01/2019
RSA-1298A-S-LP Formulario De Recomendación (Letra Grande) 04/01/2019
UB-106A Weekly Claim for Unemployment Insurance (UI) Benefits 04/01/2019
FAA-1375A Nutrition Assistance Posters 04/01/2019
CSE-1276A DCSS Hardship Program 04/01/2019
UB-106A-S Reclamo Semanal para Beneficios de Seguro por Desempleo (UI por sus siglas en inglés) 04/01/2019

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