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Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
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| Download | Number | Name | Effective Date |
|---|---|---|---|
|
CCA-1200A | About Me Questionnaire (English) | 11/01/2022 |
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CCA-1200A-S | About Me Questionnaire (Spanish) | 11/01/2022 |
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CCA-1207A | Notice of Monitoring Rights - Disclosure Verification | 06/01/2022 |
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CCA-1207A-S | Aviso Sobre Derechos de Monitorización - Verificación de Divulgación | 06/01/2022 |
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CCA-1210B | Child Care Provider Registration Agreement | 04/01/2016 |
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CCA-1210B-S | Acuerdo de Registro del Proveedor de Cuidado De Niños | 04/01/2016 |
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CCA-1211A | Request for Search of Background Checks (English) | 05/01/2022 |
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CCA-1211A-S | Request for Search of Background Checks (Spanish) | 05/01/2022 |
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CCA-1211B | Attachment to Request for Search of Background Checks (CCA-1211A) Disqualifying Acts (English) | 04/01/2021 |
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CCA-1211B-S | Attachment to Request for Search of Background Checks (CCA-1211A-S) Disqualifying Acts (Spanish) | 04/01/2021 |
| Download | Number | Name | Effective Date |
|---|---|---|---|
|
EAP-1012A-S | Limited Authorization to Release Records Transfer of LIHEAP Application to Community Navigation Provider (Spanish) | 06/01/2024 |
|
ES-935 | Claimant’s Affidavit of Federal Civilian Service, Wages, and Reason for Separation - UCFE | 12/01/2018 |
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ESA-1126A | Cancellation of Direct Deposit (English) | 04/01/2020 |
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ESA-1126A-S | Cancellation of Direct Deposit (Spanish) | 04/01/2020 |
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ESA-1193A | Veteran's Assessment Tool (English) | 08/01/2024 |
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ESA-1193A-S | Veterans' Assessment Tool (Spanish) | 08/01/2024 |
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ESA-1220A | Work Readiness Self-Assessment | 09/01/2018 |
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ESA-1220A-S | Autoevaluación Para Determinar La Preparación Laboral | 09/01/2018 |
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ESA-1297A | Assurances for Interstate and Interstate Clearance Orders | 05/01/2016 |
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ESA-1303A | Job Order | 04/01/2022 |
| Download | Number | Name | Effective Date |
|---|---|---|---|
|
Statistical Bulletin October 2016 | Statistical Bulletin October 2016 | 11/22/2016 |
|
Statistical Bulletin October 2017 | Statistical Bulletin October 2017 | 11/28/2017 |
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Statistical Bulletin October 2018 | Statistical Bulletin October 2018 | 11/27/2018 |
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Statistical Bulletin October 2019 | Statistical Bulletin October 2019 | 12/02/2019 |
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Statistical Bulletin October 2020 | Statistical Bulletin October 2020 | 04/11/2022 |
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Statistical Bulletin October 2021 | Statistical Bulletin October 2021 | 04/11/2022 |
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Statistical Bulletin October 2022 | Statistical Bulletin October 2022 | 11/16/2022 |
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Statistical Bulletin October 2023 | Statistical Bulletin October 2023 | 11/27/2023 |
|
Statistical Bulletin September 2013 | Statistical Bulletin September 2013 | 10/15/2013 |
|
Statistical Bulletin September 2014 | Statistical Bulletin September 2014 | 10/16/2014 |
| Download | Number | Name | Effective Date |
|---|---|---|---|
|
POX-248A- Arabic | Americans with Disabilities Act Grievance Notice - Lobby (Arabic) | 07/01/2020 |
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POX-248A- Kinyarwanda | Americans with Disabilities Act Grievance Notice - Lobby (Kinyarwanda) | 07/01/2020 |
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POX-248A- Swahili | Americans with Disabilities Act Grievance Notice - Lobby (Swahili) | 07/01/2020 |
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PPP-1122A | Limited English Proficiency (LEP) Poster (English) | 08/01/2020 |
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PPP-1122B | Limited English Proficiency (LEP) Flyer | 08/01/2020 |
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RAP-1022A | Arizona Rental Assistance (ARA) | 02/01/2024 |
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RAP-1022A-S | Arizona Rental Assistance (ARA) - (Spanish) | 02/01/2024 |
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Register Data Security | Register for Basic Data Security | 09/27/2007 |
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RRP-1012A | Refugee Medical Assistance Program (RMA) Provider Manual (English) | 02/01/2022 |
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RRP-1022A | Welcome Corps Resource Guide (English) | 04/01/2024 |