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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RSA-1390A | Statement of Services Rendered | 07/01/2020 |
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J-930-A-S | Solicitud de Adaptación Eficaz para Participar en un Programa, Servicio o Actividad | 07/01/2020 |
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POX-248 -Arabic | Americans with Disabilities Act Notice (Arabic) | 07/01/2020 |
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GCI-1085A-S | Lista de verificación para el examen de la visión | 07/01/2020 |
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GCI-1042A | Family Survey | 07/01/2020 |
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CSE-1185A | Affidavit of Credible Person Identifying Affiant (English/Spanish) | 07/01/2020 |
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POX-248 | Americans with Disabilities Act Notice | 07/01/2020 |
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POX-248 - Swahili | Americans with Disabilities Act Notice (Swahili) | 07/01/2020 |
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GCI-1042A-S | Encuesta Familiar | 07/01/2020 |
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POX-248 - kinyarwanda | Americans with Disabilities Act Notice (Kinyarwanda) | 07/01/2020 |
Download | Number | Name | Effective Date |
---|---|---|---|
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GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
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FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
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FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
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FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
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FAA-1826A-SLP | Solicitud de Representante Autorizado(a) para Asistencia Nutricional (NA) (Letra Grande) | 06/01/2023 |
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FAA-1111A | Participant Statement Verification Worksheet | 06/01/2023 |
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FAA-1440A-S | Cash Assistance Benefit Limit Extension Request (Spanish) | 06/01/2023 |
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FAA-1493A-S | Authorized Representative Request (Spanish) | 06/01/2023 |
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FAA-1493A-SLP | Nutrition Assistance Authorized Representative Request - Large Print (Spanish) | 06/01/2023 |
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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