You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1847A-XLP | Electronic Benefit Theft Replacement Request Form - Extra Large Print (English) | 10/01/2024 |
FAA-1847A-SXLP | Electronic Benefit Theft Replacement Request Form - Extra Large Print (Spanish) | 10/01/2024 |
FAA-1847A-SLP | Electronic Benefit Theft Replacement Request Form - Large Print (Spanish) | 10/01/2024 |
FAA-1847A-S | Electronic Benefit Theft Replacement Request Form (Spanish) | 10/01/2024 |
FAA-1847A-LP | Electronic Benefit Theft Replacement Request Form - Large Print (English) | 10/01/2024 |
FAA-1847A | Electronic Benefit Theft Replacement Request Form (English) | 10/01/2024 |
FAA-1842A-S | Remplazo de Beneficios de Asistencia Nutricional (NA) - Alimentos Destruidos en un Desastre o Desgracia | 10/01/2023 |
FAA-1842A | Replacement of Nutrition Assistance Benefits - Food Destroyed in a Disaster/Misfortune | 10/01/2023 |
FAA-1841A-S | Regreso a Renovaciones Regulares de MA | 09/01/2023 |
FAA-1841A | Return to Regular MA Renewals | 09/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
CCA-0041A | Fair Hearing Request | 11/01/2021 |
CCA-0039A-S | Medical Statement (Spanish) | 12/01/2022 |
CCA-0039A | Medical Statement (English) | 12/01/2022 |
CCA-0036A-S | Permission to Give Medication (Spanish) | 12/01/2022 |
CCA-0036A | Permission to Give Medication (English) | 12/01/2022 |
CCA-0031A | Verbal Notice of Eligibility (English/Spanish) | 10/01/2022 |
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
CCA-0024A | Employment and Wage Verification Statement (English) | 11/01/2021 |
CCA-0005A | Log of Accidents, Injuries or Illnesses (English/Spanish) | 12/01/2022 |
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