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Download Number Form Name Effective Date
LCR-1007A-S Informe de Visita al Hogar Suplemento Al Aviso de Derechos De Inspección y Debido Proceso 07/01/2019
GCI-1051A Follow-Up Letter 07/01/2019
FAA-0001A Application for Benefits 07/01/2019
FAA-0001A-S Solicitud de Beneficios 07/01/2019
FAA-1249A-LP Verification of Disability (Large Print) 07/01/2019
GCI-1051A-S Follow-Up Letter (Spanish) 07/01/2019
FAA-0574A-XLP Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) 07/01/2019
FAA-0574A-XLPS Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) 07/01/2019
UB-099-Y Certification of Understanding (Eng/Span) 07/01/2019
GCI-1094A Primary Caregiver Visit Log 07/01/2019

Download Number Form Name Effective Date
30th Month Aug-2018 30th Month Financial Report FY-2019 through Aug-2018 12/12/2018
30th Month Sep-2018 30th Month Financial Report FY-2019 through Sep-2018 12/10/2018
Statistical Bulletin October 2018 Statistical Bulletin October 2018 11/27/2018
GCBVI 2018 Governor's Council in Blindness and Visual Impairment (GCBVI) Annual Report for SFY 2018 11/21/2018
DES Welfare-2018 DES Welfare Report 2018 11/16/2018
DES Welfare-2017 DES Welfare Report 2017 11/16/2018
Statistical Bulletin September 2018 Statistical Bulletin September 2018 11/05/2018
6AAC17 Five-Year Review Report - General Assistance Program 10/31/2018
CCDF Plan FFY 2019-2021 CCDF State Plan FY2019-FY2021 10/30/2018
Statistical Bulletin August 2018 Statistical Bulletin August 2018 09/28/2018

No results available.

Download Number Form Name Effective Date
FAA-1714A Mid Approval Contact (Lobby) 05/01/2019
FAA-1714A-S Contacto en el punto Medio de la Aprobación (Lobby) 05/01/2019
FAA-1407A-S Guía de Referencia de WIC de Arizona 05/01/2019
FAA-1407A Arizona WIC Reference Guide 05/01/2019
AAA-1316A SNAP-O Partnership 04/01/2019
UIT-1191A Bulk UI Tax Rate Request Process and Information 04/01/2019
CSE-1276A DCSS Hardship Program 04/01/2019
FAA-1375A Nutrition Assistance Posters 04/01/2019
WIO-1121A Connecting Business with Job Seekers - Services for Employers 04/01/2019
WIO-1086A Connecting People and Jobs 04/01/2019


Download Number Form Name Effective Date
Statistical Bulletin June 2019 Statistical Bulletin June 2019 07/15/2019
RSA-1312A-S Autorización Para Divulgación De Información De Salud a RSA 07/01/2019
FAA-0001A Application for Benefits 07/01/2019
RSA-1213A-LPS Beneficios por discapacidad en Arizona 101 (Letra Grande) 07/01/2019
UB-099-Y Certification of Understanding (Eng/Span) 07/01/2019
DDD-2025A American Indian Health Plan Fee-for-Service Claims Submission Guide 07/01/2019
CSE-1251A Fact Sheet for Minor Parents (English/Spanish) 07/01/2019
FAA-0001A-S Solicitud de Beneficios 07/01/2019
CCA-1259A DES Certified Home-Based Child-Care Provider Pre Application 07/01/2019
GCI-1051A Follow-Up Letter 07/01/2019

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