Finance and accounting industry. STATEOFCALIFORNIA-HEALTHANDHUMANSERVICESAGENCY CALIFORNIADEPARTMENTOFSOCIALSERVICES. The AREP information shall be reviewed at recertification. EMC %%EOF This authorization expires on _____, or six (6) (DATE) months from the date of signature, whichever is sooner. You do not need to print these forms as they will be mailed to you after you submit your initial application form. 2y.-;!KZ ^i"L0- @8(r;q7Ly&Qq4j|9 "F$H:R!zFQd?r9\A&GrQhE]a4zBgE#H *B=0HIpp0MxJ$D1D, VKYdE"EI2EBGt4MzNr!YK ?%_(0J:EAiQ(()WT6U@P+!~mDe!hh/']B/?a0nhF!X8kc&5S6lIa2cKMA!E#dV(kel }}Cq9 Al hacer clic en el botn Aceptar, acepta el uso de estas tecnologas y el procesamiento de tus datos para estos propsitos. endstream endobj 73 0 obj <>stream 0 A: . Document extensions or changes to the designated AREP in ACES. /Tx BMC fSZHti>DB6O,? AD 4324 (2/21) - Adoption Questionnaire I This is a large PDF file. endstream endobj 890 0 obj <>/Subtype/Form/Type/XObject>> stream Your authorized representative may act for you on all duties related to your Medi-Cal eligibility and enrollment. The following forms need to becompleted duringfortheCalFreshapplication and renewal processes. }3$@JAt " ]YL /@ > Cal Fresh Forms + Resources San Diego Hunger Coalition endstream endobj 231 0 obj <> stream HyTSwoc [5laQIBHADED2mtFOE.c}088GNg9w '0 Jb Medi-Cal Forms - California Name . endstream endobj 232 0 obj <> stream xwpw#8N.d'6nN,z1yN.Xz[cgN}'P X Chinese A-M - California Department of Social Services 961 0 obj <> endobj Please refer to the Payees on Benefit Issuances - Authorized Representatives chapter, WAC 388-460-0005 through 460-0015 for AREP rules specific to the Basic Food (SNAP) program. AD 4320 (6/22) - Adoption Assistance Program (AAP) Agreement . The Public Disclosure Unit is responsible for approving or denying requests for disclosure of confidential information. An AREP assists the client with the application, recertification, and general eligibility processes. wG xR^[ochg`>b$*~ :Eb~,m,-,Y*6X[F=3Y~d tizf6~`{v.Ng#{}}jc1X6fm;'_9 r:8q:O:8uJqnv=MmR 4 endstream endobj startxref 0 %%EOF 887 0 obj <>/Metadata 39 0 R/PageLayout/OneColumn/Pages 67 0 R/StructTreeRoot 74 0 R/Type/Catalog/ViewerPreferences<>>> endobj 934 0 obj <> stream Authorized Representative Name: Authorized Representative Address: Authorized Representative Telephone Number: I authorize the above designated individual to act as my representative for the purposes checked below. AD 931 (2/20) - Independent Adoption Of A Foreign-Born Child - Statement Of Acknowledgment. 1B114F All Forms N/A Authorization for Release of Information Authorized Representative CSF 14 506481 Reason Code County Category NOA Action Document Name Number Template 300001 Placer Forms Affidavit to N/A Obtain Duplicate Warrant All 662 609763 300001 Santa Barbara Forms N/A Affidavit to Obtain Duplicate of Lost or 222 0 obj <> endobj 291 0 obj <>/Filter/FlateDecode/ID[('\315mre\3113.\033X\030>\fU\216\257) (Ruz\246o\3345M\225\321\256\261D\027\337\\)]/Index[222 70]/Info 219 0 R/Length 114/Prev 267957/Root 223 0 R/Size 292/Type/XRef/W[1 3 1]>> stream Parts of a Release Authorization Form. We help individuals, families, and communities access services and public benefits that make a difference in their lives. Downloadable Medical Assistance Provider Forms - Department of Human csf 14 authorization for release of information authorized representative 9A~c+e!0Ow ;3`yKn:nSL5)@~rMBEr~u8pAYh="4e3&X\6H(Tzzop|kUM.Mwcfe FKJj6 B^v 14-532 Authorized Representative Author: Brombacher, Millie A. endstream endobj 234 0 obj <> stream endstream endobj startxref AUTHORIZED REPRESENTATIVE,20. Choose My Signature. endstream endobj 888 0 obj <> endobj 889 0 obj <>/Subtype/Form/Type/XObject>> stream El asesor que se le asignar tendr una comunicacin directa desde el principio hasta el final de su gestin y entrega.La persona asignada para el proceso de Apostilla en los distintos Ministerios, Cmaras, Colegios y Organismo Oficiales que requiera, con ms de 20 aos de experiencia Contamos tambin con traductores Jurados reconocidos por el Ministerio de Asuntos Exteriores, Nuestro personal est altamente cualificado. Third Party Liability Notification. Semi-Annual Report SAR7 . Medi-Cal Personal Injury Program. The name, address, contact numbers, and date of birth are the common information found on this section. V)gB0iW8#8w8_QQj@&A)/g>'K t;\ $FZUn(4T%)0C&Zi8bxEB;PAom?W= There are times when we can share confidential client data without the client's permission: To learn more about when it is permissible to share client information please refer to DSHS Administrative Policy 5.02, Section D;4. %%EOF p()md). Building partnerships and connections through outreach, giving, and volunteering. A relative of the patient may also use an authorization form under this category especially of the patient is a minor and requires a guardian ad he stays in the medical clinic. This form authorizes the release of medical information to the representative . Photocopies of this authorization shall be considered as valid as an original. June 29, 2022; creative careers quiz; hb```52@(1{yPdVDHl] O_ $8:)HX 2~F^HHi,l,,&@Spo//;Q#!k84#inpu w S*} # Medical and healthcare agencies. {=:^zu*EQ `mm:HZ2B dIB,bV@@iE @}r:H:2utsb"tt#SIw$ 'Gb'!1.!H]`-T H\n@E,Sec%Ri:`!aw`WYtmM&O.LfeCgizJ>VCw)}{2u7a^~|nfm.Lf3x|_1}cT}jy0V!de1UB|gr~fT"`mX p@ % (jP 4. Forms and Brochures - California Department of Social Services HPN07UI DJd(T$0tssdq,N{;Z5uczrhF: mH^_ -1j$#w+:gnUs?7]C-=HT;.h`_bX{,UF$@rI4Pl^G(b$a?&?/V,] %PDF-1.6 % hb```"oV)af`0p &I0nafX4AD?P`YJD!NMV$2F3{i1 032p040060`}Pht@/ABo].T.`FY?R~04\.zd'&?Jl| @ H/M _gL7YG{b>v#F>//C1n taqOY__5UUeKZ\Uq2~?&Ymn J?4y/*Eue!~VUYTqZy?6u=gD Nx>mp ((J,8p Fh csf 14 authorization for release of information authorized representative To order forms, complete the form at the bottom of this page. Legal Guardianship is designated by coding the AREP screen Rep Type field in ACES with the following: Power of Attorney for cash, medical, and basic food is designated by coding the AREP screen Rep Type field in ACES with AD or NA. EMC f8EN*ZY\?PQH~>}vfy*2`V6]k=_Oh5p|0 t6?2fS.\v4 `c9-rf;(T3:5I_d81Xuowf'dzG6_`EpC#b@FC>@M\4f+xTK9s/)-xL);P H^t-$?Lo)17?R|osx?t81x{e4RlP])[Y>. Form processing may be delayed if fields with an asterisk are not filled out. %%EOF 102 0 obj <>stream How to identify and code an AREP in our automated systems. /Tx BMC CF 32 (6/13) - CalFresh Request For Contact. CAPI C-776: CAPI Authorized Representative Form EMC C-761 Bay Area Consortium CAPI Transmittal, 50-85A Language Preference Form Cover Sheet (multi-language), 50-85 Language Preference Form (multi-language), C-134 Cash Assistance Program for Immigrants (CAPI) General Eligibility Information, Payment Levels and Reporting Responsibilities, 20-02 You May Be Required to Apply for SSI, SSP 14 Authorization for Reimbursement of Interim AssistanceChinese,Spanish, SOC 453 CAPI Statement of Household Expenses and ContributionsChinese,Spanish, SOC 455 CAPI State Interim Assistance Reimbursement AuthorizationChinese, Spanish, SOC 809 CAPI Indigence Exception StatementChinese, Spanish. csf 14 authorization for release of information authorized representative. endstream endobj 897 0 obj <> stream See WORKER RESPONSIBILITIES. csf 14 authorization for release of information authorized representative. The DSHS 14-012(x) consent form is a Health Insurance Portability and Accountability Act (HIPAA) compliant form designed for use by the client to authorize an exchange of information outside of basic eligibility information shared with an AREP. PDF Authorization for Use or Disclosure of Protected Health Information - HNL Create your signature and click Ok. Press Done. endstream endobj 900 0 obj <> stream Release of Information . 166 0 obj <>/Encrypt 141 0 R/Filter/FlateDecode/ID[<7D6D17A302C5ACFD3A69D63CA072DE31><93B97E192985F34987B8D519A2DF3746>]/Index[140 61]/Info 139 0 R/Length 97/Prev 26174/Root 142 0 R/Size 201/Type/XRef/W[1 2 1]>>stream SIGNATURE . Quieres probar una bsqueda? Esta web utiliza cookies propias y de terceros para su correcto funcionamiento y para fines analticos. 269 0 obj <>stream 140 0 obj <> endobj endstream endobj 895 0 obj <>/Subtype/Form/Type/XObject>> stream PDF Consent - Washington nQt}MA0alSx k&^>0|>_',G! %PDF-1.7 % /Tx BMC endstream endobj 229 0 obj <> stream CSF 14: Authorization for Release of Information - Authorized Representative. AD 100A (7/20) - Authorization For Release, Use And/Or Disclosure Of Health Information AD 165 (3/15) - Presumed Father's Consent To Adoption When Denying He Is The Biological Father (In Or Out-Of-California) - Independent Adoptions Program To view a particular form, click on VIEW PDF the table below. 0,00 . I appoint this individual _____ / _____ Name of individual Name of organization . The DSHS 17-063 authorization form and the HCA 80-020 authorization for release of information form are HIPAA compliant forms designed for use by the client to authorize the release of existing documents to a specified individual or agency. 9L $? U The patient or legally authorized representative must sign and date the form. apes chapter 4 quizlet multiple choice. Both the client and Alternate Card Holder must complete and sign the DSHS 27-130 form. Clients can makechanges to an AREP's information, such as address or phone numberverbally but wemustclearlydocument these changes in the case record. PDF State of California Health and Human Services Agency Department of The Information to be Released. AMedical Authorization Formmay be completed by the administering physician to acquire the medical records of his patient. FREE 15+ Sample Release Authorization Forms in PDF | MS Word | Excel SECTION I. Authorization of Minors: If the patient is a minor (under 18 years of age) the authorization must be signed by a parent or legal guardian. Calfresh Authorized Representative Form - signNow PDF Appointment of Authorized Representative Part A: Tell us about you its regulations and Authorized Representative/ HIPAA Form PLEASE PRINT CLEARLY * This information is mandatory. Tips for Using Adobe PDF Files. pvphVwh h E^z8rn+>m>^#r^n/^_^Nsr#\rLL&I\R&4N8/` _%c H\0 NOTE: Some links on this page are documents in Adobe . CF 37 (7/15) - Recertification For CalFresh Benefits. Form . calfresh forms csf 14 authorized representative calfresh calfresh proof of income . When to require the DSHS 14-012 (x) consent form. Decide on what kind of signature to create. 0 If an individual AREP is representing an organization, other individuals from that organization within the same department may also act as an AREP. Notice to Terminating Employees. *{PK\RL-/i=,~6%2yT'EN5e IN2ZNdb9K;5> FDU 113 (7/22) - Civil Rights Annual Training Checklist For CSFP And TEFAP, FS 31 ENG/CH (2/09) - Notice To All Food Stamp Recipients - Important-Please Read - Things You Need To Know, FSP 1 (8/14) - Family Stabilization Program Evaluation Request, FSP 2 (1/21) - Family Stabilization Program Denial Notice, FSP 3 (8/14)Family Stabilization Program Notice of Change in Program Status, GEN 111 (11/20) - Employer Statement Form, GEN 1179 (5/18) - Complaint of Discrimination, GEN 1388 (9/15) - Language Accessibility Services Complaint Form, GEN 1390 (3/17) - Informing Notice - Regarding An Action Taken On Your Case, HCS 100 (11/21) - Application For Home Care Aide Registration or Renewal, IHSS-E 002 (1/17) - In-Home Supportive Services (IHSS) Program Notice To Provider For Discontinuance Of Exemption From Workweek Limitations For Extraordinary Circumstances, IHSS-E 003 (1/17) - In-Home Supportive Services (IHSS) Program Notice To Recipient For Discontinuance Of Exemption From Workweek Limitations For Extraordinary Circumstances, IHSS-E 004 (4/17) - In-Home Supportive Services Program Notice Of Non-Receipt Of Exemption From Workweek Limits Provider Agreement (APD 006), IHSS-E 005 (1/17) - In-Home Supportive Services Program Notice Of Ineligibility To Request Exemption From Workweek Limits For Extraordinary Circumstances (Exemption 2) - Provider, IHSS-E 006 (4/17) - In-Home Supportive Services Program Notice To Provider Of Expiration Of Exemption From Workweek Limits, IHSS-E 007 (4/17) - In-Home Supportive Services (IHSS) Program Notice To Recipient Of Providers Expiration Of Exemption From Workweek Limits, KG 2 (1/11) - Statement Of Facts Supporting Eligibility For Kinship Guardianship Assistance Payment (Kin-GAP) Program, KG 3 (12/11) - Kin-GAP Mutual Agreement For Nonminor Former Dependents, KG 4 (2/14) - Kinship Guardianship Assistance Payment (Kin-GAP) Program - Nonrecurring Legal Guardianship Expenses Agreement, KG 5 (2/14) - Kinship Guardianship Assistance Payments (Kin-GAP) Program Nonrecurring Legal Guardianship Expenses Form, LIC 00 (8/17) - Conversion to Resource Family: Release of Information, LIC 00A (2/17) - Conversion - Resource Family Application, LIC 01A (8/21) - Resource Family Application, LIC 01C (7/16) - Resource Family Application-Confidential, LIC 03 (8/21) - Resource Family Home Health And Safety Assessment Checklist Document For Agency Use Only, LIC 05A (8/21) - Resource Family Approval Certificate, LIC 12 (8/21) - Resource Family Approval Document Alternative Plan (DAP), LIC 126 (3/21) - Entrance Checklist - Family Child Care Homes, LIC 184B (3/22) - Notification Of Incomplete Application - Family Child Care Home, LIC 184C (3/22) - Notification Of Incomplete Application (NOIA) Child Care Centers -Pre-30-Day NOIA, LIC 184D (3/22) - Notification Of Incomplete Application (NOIA) Child Care Centers - 30-Day NOIA, LIC 184E (3/22) - Notice Of Incomplete Application (NOIA) Changes To Corporate Status, LIC 198 (1/22) - Child Abuse Central Index Check For County Licensed Facilities, LIC 198B (8/21) - Out-Of-State Child Abuse/Neglect Report Request, LIC 200 (2/11) - Application For A Community Care Facility or Residential Care Facility For The Elderly License, LIC 279 (2/09) - Application For A Family Child Care Home License, LIC 279B (1/22) - Current Children In Your Home - Application For A Family Child Care Home License, LIC 281D (1/17) - Application And Supporting Documentation Checklist Foster Family Agency, LIC 281E (1/17) Application And Supporting documentation Checklist Short - Term Residential Therapeutic Program, LIC 300A (01/22) - Removal Confirmation - Exemption Needed, LIC 301E (10/22) - Reference Request - Exemption, LIC 311A (2/22) - Records To Be Maintained At The Facility - Child Care Centers, Infant Centers, School-Age Centers and Child Care Centers For Mildly Ill Children, LIC 421CC (6/22) - Civil Penalty Assessment Child Care, LIC 421D (CC) (8/22) - Civil Penalty Assessment Death/Serious Injury/Physical Abuse (Child Care), LIC 311D (2/22) - Forms/Records To Keep In Your Family Child Care Home, LIC 421A (6/22) - Civil Penalty Assessment (Unlicensed Facility), LIC 508D (8/17) - Out-Of-State Disclosure And Criminal Record Statement, LIC 610A (01/22) - Emergency Disaster Plan For Family Child Care Homes, LIC 610B (6/02) - Emergency Plan For Foster Family Homes, LIC 613A (8/08) - Personal Rights - Child Care Centers, LIC 613B (6/22) - Personal Rights Childrens Residential Facilities, LIC 624B (8/08) - Unusual Incident/Injury Report - Family Child Care Home, LIC 700 (10/19) - Identification And Emergency Information Child Care Centers/Family Child Care Homes, LIC 702 (8/08) - Child's Preadmission Health History - Parent's Report, LIC 995 (9/08) - Child Care Center - Notification Of Parents' Rights, LIC 995A (8/08) - Family Child Care Home - Notification Of Parents' Rights, LIC 995B (8/08) - Family Child Care Home Addendum To Notification Of Parents' Rights (Regarding Removal/Exclusion), LIC 995C (8/08) - Family Child Care Home Addendum To Notification Of Parents' Rights (Regarding Reinstatement), LIC 995E (10/09) - Caregiver Background Check Process, LIC 995F (10/09) - Caregiver Background Check Information, LIC 9058 (3/22) - Applicant/Licensee Rights, LIC 9108 (3/05) - Statement Acknowledging Requirement To Report Suspected Child Abuse, LIC 9148 (9/00) - Earthquake Preparedness Checklist (EPC), LIC 9149 (8/14) - Family Child Care Home Property Owner/Landlord Consent Form, LIC 9150 (8/14) - Parent Notification - Additional Children in Care, LIC 9151 (8/14) - Property Owner/Landlord Notification Family Child Care Home, LIC 9163 (3/21) - Request Live Scan Service - Community Care, LIC 9217 (5/22) - Pre-Licensing Readiness Guide - Family Child Care Home, LIC 9221 (5/22) - Parent Consent For Administration Of Medications And Medication Chart, LIC 9224 (8/08) - Acknowledgement Of Receipt Of Licensing Reports, LIC 9227 (8/20) - Individual Infant Sleeping Plan, M16-120B (6/11) - EBT Dormat Account: Suspend, M16_120C (7/02) - EBT Dormant Account - Reactivate, M16_325B (7/02) - EBT Incomplete Document, M16-325E (8/08) - Direct Deposit Cancellation, M16_505A (7/02) - Designated Alternate Cardholder, M16_505B (7/02) - Designated Alternate Cardholder - Need Additional Fact, M16_505D (7/02) - Designated Cardholder - Deny, M20-003 (7/01) - Duplicate Aid Match, Discontinue, M20-003A (7/01) - Duplicate Aid Match, Deny, M20-353C (6/98) - Fraud, Penalty Applied to AU, M20-353D (6/98) - Fraud, Penalty Applied to AU, M20-353F (6/98) - Fraud, Penalty Stops - Change, M40_105 (11/14) - Failed to Provide SSN When Received or Failure to Cooperate, M40_105A (11/14) - Failed to provide SSN or proof of completed SSN Application, M40_105B (7/98) - Change: Required Documentation Received, Immunization, M40_105C (11/14) - Notice of Action - Immunizations, M40_105D (7/98) - Change: Required Documentation Received, School Attendance, M40-105D1 (1/15) - Notice Of Action - School Attendance, M40_105E (2/15) - Notice of Action - School Attendance, M40_105I (3/00) - Deny: SFIS Requirements, Failure to Cooperate, M40_105J (3/00) - Deny: SFIS Requirements, Refusal to Cooperate, M40-107 (6/11) - Addendum 1 - Child Support Collection For CalWORKs 48-Month Time Limit Exemption, M40-107 (4/21) - Addendum 1 - Child Support Collection For CalWORKs 60-Month Time Limit Exemption, M40-107 (6/11) - Addendum 2 - Child Support Collection For CalWORKs 48-Month Time Limit Exemption, M40-107 (4/21) - Addendum 2 - Child Support Collection For CalWORKs 60-Month Time Limit Exemption, M40_107A (11/02) - Other: CalWORKs 60-Month Time Limit, Time on Aid (no previous NOA issued), M40-107A (4/21) - Time On Aid (no previous NOa issued), Other, M40_107B (6/11) - Time on Aid at Redetermination, M40-107B (4/21) - Time On Aid at Redetermination, M40-107C (6/11) - Time On Aid Between 42th and 46th, M40-107C1 (9/20) - Time on Aid Between 54th and 57th Month - Use Starting May 1, 2022, M40-107D (6/12) - Time On Aid To Former CalWORKs Recipients, M40-107D (4/21) - Time On Aid To Former CalWORKs Recipients, M40_107F (6/11) - Extended Beyond 48 Months Of Aid, M40-107F (4/21) - Extended Beyond 60 Months of Aid, M40-107F1 (4/21) - Extender Met After 60th Month, M40_107F1 (6/11) - Extender Met After 48th Month, M40_107G (11/02) - Discontinue: CalWORKs 60-Month Time Limit, 60th month on Aid, M40-107G (4/21) - 60th Month On Aid, Discontinue, M40_107H (11/02) - Change: CalWORKs 60-Month Time Limit, 60th month on Aid MFG child only, M40-107I (7/22) - 60th Month On Aid, No eligible child, Discontinue, M40_107J (11/02) - Partial Approval: CalWORKs 60-Month Time Limit, Time-Out Adult, M40-107J (4/21) - Timed-Out Adult, Partial Approval, M40_107J1 (6/11) - Approval after 48 Months On Aid, M40-107J1 (4/21) - Approval After60 Months on Aid, M40_107K (6/11) - Increase Grant due to TOA Adjustment, M40-107K (4/21) - Increase Grant due to TOA Adjustment, M40_118A (8/96) - Application Processing Deny, M40-125B SAR (4/16) - Restore After a SAR7 Discontinuance, M40-125C SAR (4/16) - Incomplete Semi-Annual Report (SAR7) Denial of Restoration, M40 129B (11/09) - Full Payment - Approve, M40-129B1 (12/90) - Approval after Immediate Need Payment, Approve, M40-129D1 (11/14) - Procedural Requirements, Deny, M40-129D2 (12/90) - Procedural Requirements, Deny, M40-129D3 (12/90) - Procedural Requirements, Deny, M40-129D4 (9/00) - Procedural Requirements, Deny, M40_129D5 (11/14) - Failed to Provide Proof of SSN Application, Deny, M40-171A (11/14) - Failure to Cooperate, Deny, M40-171B (5/91) - Refusal to Cooperate, Deny, M40_171C (6/98) - Approve: Application Processing, Basic Approval, M40_171M (7/87) - Denial: Application Processing, Not a California Resident, M40 181 (9/13) - SAWS 2 Redetermination Of Eligibility, M40-181A (11/14) - SAWS 2 Redetermination/Other Essential Information, M40_181E (11/14) - SAWS 2 PLUS Redetermination Immunizations/School Attendance, Change, M40 181C SAR (9/13) - Notice Of Action - Balderas Reminder Notice, M40-181F (7/22) - No Change at Redetermination, M40-195A (8/22)- ICTNotice Of Transfer, Sending, M40-195B (8/22) - ICT Notice Of Transfer, Receiving, M41_401A (12/86) - Denial: Deprivation, No Deprivation, M41_440F (6/98) - DENY: Deprivation, CalWORKs-U, 100 Hours Work Rule, M41_450A (1/98) - Deprivation: Uniformed services - Deny, M42_101B (11/14) - Age and School Requirements, M42-101C (11/14) - Age and School Requirements, Discontinue, M42 207A (10/15) - Over Property Limit, Deny, M42_221K (4/99) - Suspend: Property, Transfer w/out Fair Consideration, M42_221L (4/00) - Suspend: Income, Transfer w/out Fair Consideration, M42-431A4 (11/14) - No Eligible Noncitizen Status/Proof of Eligible Noncitizen Status, Discontinue, M42-769A (11/14) - Apply $100 Cal-Learn Penalty, M43_119E (1/98) - Sponsored Non-Citizen: Some needs Met - Change, M43_119G (11/14) - Missing SAR 72, Change, M43-119H (11/14) - Missing SAR 72, Discontinue, M43_119I (7/98) - Change: Sponsored Alien, Deemed & Family Property, M43_119J (7/98) - Change: Sponsored Alien, Deemed Property, M43_119K (7/98) - DENY: Sponsored Alien, Deemed Property & Family Property, M43_119L (7/98) - DENY: Sponsored Alien, Deemed Property, M43_119M (1/98) - Sponsored non-Citizen: Deemed Income-Change, M44_113A (6/98) - Change: Income, Change in Income, M44_113G1 (6/98) - Change: Income, Change in Income, M44_133D (6/98) - Change: Income, Change in Income, M44_133Q (6/98) - Change: Income, Change in Income, M44_133S (10/02) - Minor Parent Financial Eligibility (Change), M44-133T (9/20) - Minor Parent, Financial Eligibility, Partial Approval, M44_133V (10/02) - Minor Parent Financial Eligibility (Suspend), M44-207I SAR (4/16) - Financial Eligibility, M44_207J (6/98) - DENY: Income, Financial Eligibility Test, M44_207L (6/98) - SUSPEND: Income, Financial Eligibility Test, M44-207K (5/20) Financial Eligibility, Discontinue, M44-207K1 (5/20) - Minor Parent, Financial Eligibility, M44-207M (8/20) - Financial Eligibility, Deny, M44-211B (10/21) - Expanded Temporary HA For Applicants Fleeing DV, Approve, M44-211D (10/21) - Temporary Shelter And/Or Permanent Housing, M44_211L (7/01) - Change: Special Needs - Pregnancy, M44-211N (9/21) - No Longer Pregnant, Change, M44_305 (9/97) - Minor Parent Change of Payee, M44_307A (11/15) - Voucher/Vendor Payment, Other, M44-315A (5/20) - $10 Minimum Payment, Change, M44-315A (8/21) - $10 Minimum Payment, Change, M44_315B (9/98) - CHANGE: Aid Payment Levels, ICT between Reg-2, M44 315C (4/09) - Notice of Action - Four Percent Grant Reduction, M44 316 (8/04) - No Change/Mid Quarter Reporting, M44 316 SAR (9/13) - No Change/Mid-Period Reporting, M44 316A (9/13) - Notice Of Action - Not Yet Changed, M44 316B (9/13) - Notice Of Action - Change In Income Over IRT, M44-316C (8/22) - Notice Of Action - No Change/Mid-Period Report Of Property, M44 316C SAR (10/17) - No Change/Mid-Period Report of Property, M44 316D SAR (9/13) - Notice Of Action - Change In Income, M44-316E (10/16) - Mid-Period Change Due To The Death Of A Child, M44_340 (4/00) - Approval: Underpayments, Underpayment Adjustment, M44 340C (8/12) - Underpayment Adjustment, M44_350A (11/11) - Overpayment Adjustment, M44_350E (11/11) - Excess Property Overpayment Adjustment (W/O Good Faith), M44_350F (11/11) - Excess Property Overpayment Adjustment (W/O Good Faith), M44_350G (11/11) - Excess Property O/P Adjustment (with Good Faith), M44_350H (11/11) - Excess Property Overpayment Adjustment (With Good Faith), M44-350I SAR (9/13) - Notice Of Overpayment, M44-350J (3/12) - Overpayment To Be Stopped Effective February 1, 2012, M44-350K (11/21) -EBT Replacement Denial, M44_352A (11/11) - Notice of O/P and Demand, M44-352H (11/11) - Overpayment Adjustment, M44 352H SAR (9/13) - Notice Of Action Overpayment Adjustment, M44_401A (6/98) - Approve: Hardship Supplement RISP - MFG, M44_401B (6/98) - Deny: Hardship Supplement RISP - MFG, M81_215A (6/98) - DENY: Aid Payments, Diversion payment provided, M81_215B (6/98) - DENY: Aid Payments, Diversion services provided, M81_215D (6/98) - Change: Aid Payments, Diversion Repayment Stops, M82-506 (6/98) - Change: Assignment of Support Rights, Failure to Cooperate, M82-506A (6/98) - Partial Approval: Assignment of Support Rights, Failure to Cooperate, M82-510 (6/02) - Failure to Cooperate, Change, M82-510A (6/98) - Change: Support Process/Assignment, Cooperate, M82-812 (4/04) - Family Reunification/Zero Grant, M82-820A (9/21) - No Eligible Person, Deny, M82-832A (2/99) - Change: Aid Payments, Fleeing Felons, M82-832B (2/99) - Partial Approval: Application Processing, Fleeing Felons, M82-832E (4/15) - Eligible Person Leaving AU, Change, M82-832F (4/15) - Eligible Person Leaving AU, Discontinue, M82-832G (6/18) - Eligible/Mandatory/Optional Person Leaving AU, M82-832H (10/20) - Child Does Not Meet Requirements (SB 380), M82-836A (8/91) - Denial: Au Composition, Unborn not Eligible for Aid, M89-130 (1/02) - Restricted Account, Discontinue, M89_201 (11/96) - Minor Parent exemption: Deny, MT42_101.2D (11/04) - Fry vs Saenz Lawsuit Age Requirement - Change, MT42_101.2E (11/04) - Fry vs Saenz Lawsuit Age Requirement - Discontinue.
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