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Informes, Formularios y Políticas Administrativas

El Department of Economic Security cuenta con dos bibliotecas digitales que permiten a los usuarios buscar, informes, formularios, políticas administrativas del Departamento, así como folletos y carteles con información acerca de programas y servicios específicos.



Download Number Form Name Effective Date
JOB-1118A AZTECS Notification of Restricted Access to AHCCCS Information and Information Exchange Request 06/01/2007
DDD-1270A ISP Checklist 05/01/2007
DDD-1270A S ISP Checklist (Spanish) 05/01/2007
DDD-1426A Diaper/Brief Request for Consumers Ages 3-21 03/01/2007
DDD-1164A Attendant Care Progress Notes 02/01/2007
UC-247 Application and Agreement for Severable Portion Experience Rating Transfer 10/01/2006
FA-264-PDS Acuerdo de Responsabilidad Personal (PRA) 10/01/2006
DD-417-1 Behavior Modifying Medication Review (Page 1) 08/01/2006
DD-417-2 Behavior Modifying Medication Review (Page 2) 08/01/2006
DD-417-3 Behavior Modifying Medication Review (Page 3) 08/01/2006



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Download Number Form Name Effective Date
CSE-1249A Father Matters Referral 04/01/2017
UB-101-A Work Search Log (Eng/Span) 04/01/2017
DDD-1790A Withdraw HCBS Certification 04/01/2017
CCA-1114A Contractor Eligibility Verification 04/01/2017
CSE-1274A My Child Support Services Login 04/01/2017
CSE-1157A Non-Custodial Parent Request for Administrative Review (Eng/Span) 04/01/2017
UB-106-T Continued Claim 04/01/2017
UB-106-T-S Reclamo Continuo 04/01/2017
Statistical Bulletin February 2017 Statistical Bulletin February 2017 03/30/2017
30th Month Jan-2017 30th Month Report January Fiscal Year 2017 03/14/2017

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