Arizona Department of Economic Security
Su Socio para un Arizona más Fuerte

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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
GCI-1094A Primary Caregiver Visit Log 07/01/2019
FAA-0077A-XLPS Solicitud de Información y Acuerdo para Proporcionar Información que Falta (Letra Extra Grande) 07/01/2019
CCA-1186A Authority to Release Information 07/01/2019
FAA-0574A-XLP Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) 07/01/2019
DDD-1622A Home Modification Requests Support Coordinator’s (SC) Checklist 07/01/2019
LCR-1007A Home Visit Report Supplement to Notice of Inspection and Due Process Rights 07/01/2019
FAA-1249A-LP Verification of Disability (Large Print) 07/01/2019
FAA-0574A-XLPS Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) 07/01/2019
LCR-1007A-S Informe de Visita al Hogar Suplemento Al Aviso de Derechos De Inspección y Debido Proceso 07/01/2019
FAA-0001A Application for Benefits 07/01/2019



Download Number Form Name Effective Date
Annual Report 2016-2017 2016-2017 DES Annual Report 05/16/2018
Public Report of AzEIP 2016 Public Report of Early Intervention Services Programs, 2016 05/14/2018
30th Month Mar-2018 30th Month Financial Report FY-2018 through Mar-2018 05/04/2018
Statistical Bulletin March 2018 Statistical Bulletin March 2018 04/17/2018
30th Month Feb-2018 30th Month Financial Report FY-2018 through Feb-2018 03/30/2018
Statistical Bulletin February 2018 Statistical Bulletin February 2018 03/26/2018
30th Month Jan-2018 30th Month Financial Report FY-2018 through Jan-2018 03/16/2018
Statistical Bulletin January 2018 Statistical Bulletin January 2018 02/28/2018
30th Month Dec 2017 30th Month Financial Report FY-2018 through Dec-2017 02/28/2018
2017 Homeless Lottery Funds Report 2017 Homeless Lottery Funds Report 02/01/2018



No results available.



Download Number Form Name Effective Date
FAA-1375A Nutrition Assistance Posters 04/01/2019
WIO-1121A Connecting Business with Job Seekers - Services for Employers 04/01/2019
WIO-1112A Arizona Reentry Program 04/01/2019
PAY-519 Child Care Programs (FY19) 04/01/2019
CCA-1253A Choosing Quality Child Care (English/Spanish) 04/01/2019
PAY-519-S Programas de Cuidado de Niños (FY19) 04/01/2019
AAA-1316A SNAP-O Partnership 04/01/2019
FAA-1513A Time Saving Tips 04/01/2019
UIT-1190A UI Tax Online Reporting 03/01/2019
WIO-1113A Workforce Reentry Program 03/01/2019



Download Number Form Name Effective Date
FAA-1493A-LPS Solicitud de Representante Autorizado (Letra Grande) 08/01/2019
FAA-1493A-S Solicitud de Representante Autorizado 08/01/2019
DDD-1328B Referral to Vocational Rehabilitation Packet 08/01/2019
FAA-1493A-XLP Authorized Representative Request (Extra Large Print) 08/01/2019
UIB-1241A Take Care of Unemployment Business by the Internet or Telephone 08/01/2019
DDD-1472C-LP ISP - Annual Review and Update Packet at Home Child (Large Print) 08/01/2019
FAA-1494A Authorized Representative Removal 08/01/2019
UIB-1241A-S Atender los Asuntos de UI por Internet o por Teléfono 08/01/2019
DDD-1472C-LPS ISP - Paquete del Repaso Anual y Actualización del ISP Menor en el hogar (Letra Grande) 08/01/2019
FAA-1701A-XLP Verification of Terminated Employment (Extra Large Print) 08/01/2019

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