You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
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FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
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FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
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AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
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FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
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FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
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CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
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FAA-0255A-S | Afirmación De Hogares Por Separado | 05/01/2023 |
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FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-1366A | Eligibility Requirements | 05/01/2023 |
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FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
Download | Number | Name | Effective Date |
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DDD-2149A | Authorization to Release Records | 08/01/2022 |
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HRP-1028A-S | Solicitud para Beneficios (TEFAP, CSFP) | 08/01/2022 |
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FAA-1570A | Cash Assistance Drug Conviction Sanction Agreement | 08/01/2022 |
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FAA-1828A | Provider Determination | 08/01/2022 |
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HRP-1033A | Commodity Senior Food Program (CSFP) ID/Transfer Card (English/Spanish) | 07/01/2022 |
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HRP-1015A | Annual Civil Rights Training (English) | 07/01/2022 |
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UIB-0101C | Work Search Plan of Action Affidavit (English) | 07/01/2022 |
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HRP-1016A | Volunteer Confidentiality | 07/01/2022 |
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UIB-0101C-S | Declaración Jurada del Plan de Búsqueda de Trabajo | 07/01/2022 |
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CCA-0231A-2022 | Child Care Assistance Unwed Minor Parent Deeming Worksheet | 07/01/2022 |
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