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Download Number Form Name Effective Date
FAA-0526A Potential Overpayment (OP) Referral 07/01/2019
FAA-1249A-XLP Verification of Disability 07/01/2019
FAA-0574A-LP Withdrawal or Stop Benefits/Appeal Request (Large Print) 07/01/2019
FAA-0001A Application for Benefits 07/01/2019
CCA-1259A DES Certified Home-Based Child-Care Provider Pre Application 07/01/2019
FAA-0574A-LPS Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) 07/01/2019
FAA-0001A-S Solicitud de Beneficios 07/01/2019
CCA-1260A Back Up Provider Application 07/01/2019
DDD-1972A Application for Eligibility Determination Packet 07/01/2019
RSA-1312A Authorization for Disclosure of Health Information to RSA 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-1407A-S Guía de Referencia de WIC de Arizona 05/01/2019
RSA-1213A Disability Benefits 101 05/01/2019
FAA-1513A Time Saving Tips 04/01/2019
WIO-1086A Connecting People and Jobs 04/01/2019
PAY-519 Child Care Programs (FY19) 04/01/2019
WIO-1112A Arizona Reentry Program 04/01/2019
PAY-519-S Programas de Cuidado de Niños (FY19) 04/01/2019
CCA-1253A Choosing Quality Child Care (English/Spanish) 04/01/2019
AAA-1316A SNAP-O Partnership 04/01/2019
UIT-1191A Bulk UI Tax Rate Request Process and Information 04/01/2019


Download Number Form Name Effective Date
FAA-0574A-LP Withdrawal or Stop Benefits/Appeal Request (Large Print) 07/01/2019
DDD-1954A DDD Engagement 07/01/2019
FAA-0077A-XLPS Solicitud de Información y Acuerdo para Proporcionar Información que Falta (Letra Extra Grande) 07/01/2019
FAA-0574A-LPS Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) 07/01/2019
FAA-0574A-S Retirar o Suspender Beneficios/Solicitud de Apelación 07/01/2019
FAA-0032A Information Needed to Complete Your Case (English/Spanish) 07/01/2019
SSBG Plan 2019-2020 Social Services Block Grant Plan 2019-2020 07/01/2019
OEO-1011A One-Stop Centers Monitoring Checklist for ADA Compliance 07/01/2019
UB-099-Y Certification of Understanding (Eng/Span) 07/01/2019
FAA-1249A-LP Verification of Disability (Large Print) 07/01/2019

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