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-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 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-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
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FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
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FAA-0053A-LP | Verification of New/Current Employment - Large Print (English) | 05/01/2023 |
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CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
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FAA-1506A | Statement of No Income (English) | 05/01/2023 |
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CCA-1163A-S | Afidávit de Exención de Vacunación - Para Miembros del Hogar de 13 años de edad y Menores | 05/01/2023 |
Download | Number | Name | Effective Date |
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FAA-1570A-S | Acuerdo de Sanción de Asistencia en efectivo (CA) por condena de drogas | 08/01/2022 |
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DDD-2149A | Authorization to Release Records | 08/01/2022 |
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HRP-1028A | Application for Benefits (TEFAP, CSFP) | 08/01/2022 |
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FAA-1828A | Provider Determination | 08/01/2022 |
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HRP-1005A | TEFAP Monthly Inventory and Participation Report (MIPR) | 07/01/2022 |
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HRP-1039A | Commodity Senior Food Program (CSFP) Participant Rights and Obligations | 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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HRP-1039A-S | Programa Suplementario de Comestibles Básicos (CSFP) Derechos y obligaciones del participante | 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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HRP-1015A | Annual Civil Rights Training (English) | 07/01/2022 |
Download | Number | Name | Effective Date |
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DDD-1745A | Vehicle Safety Buckle Up - Q&A's (English) | 05/01/2016 |
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UIB-1219B | How to File Your Weekly Claim (Bilingual) | 04/01/2016 |
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UIB-1221B | How To Apply for UI Benefits (Bilingual) | 04/01/2016 |
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DDD-1627A | FACT SHEET - Advance Directives End of Life Care (Eng/Spa) | 06/01/2015 |
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DDD-1627B | FACT SHEET - Blood Lead Poisoning | 06/01/2015 |
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DDD-1627C | FACT SHEET - Immunizations (Shots) (English/Spanish) | 06/01/2015 |
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DDD-1717A | Hot Topics - Heat Hazards | 05/01/2015 |
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DDD-1698A | Dental Care Ages Birth - 21 (English) | 04/01/2015 |
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DDD-1698A-S | Dental Care Ages Birth - 21 (Spanish) | 04/01/2015 |
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DDD-1700A | Keep Your Baby Healthy | 02/01/2015 |
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