Ariz. Admin. Code § R6-12-201 - Application

A. Any person may apply for CA by filing, either in person or by mail, a Department-approved application form with any FAA office.

B. The application file date is the date any FAA office receives an identifiable application. An identifiable application is 1 which contains, at a minimum, the following information:

1. The legible name and address of the person requesting assistance; and

2. The signature, under penalty of perjury, of the applicant or the applicant's authorized representative, or, if the applicant is incompetent or incapacitated, someone legally authorized to act on behalf of the applicant.

C. In addition to the identifiable information described in subsection (B), a completed application shall contain:

1. The names of all persons living in the applicant's dwelling and the relationship of such persons to the applicant,

2. A request to receive cash benefits which complies with the requirements of R6-12-202, and

3. All other financial and non-financial eligibility information requested on the application form.

D. An application for CA is automatically treated as an application for AHCCCS medical benefits.

Notes

Ariz. Admin. Code § R6-12-201

Adopted effective November 9, 1995 (Supp. 95-4). Amended effective July 31, 1997, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 97-3).

The following Section was amended under an exemption from the provisions of A.R.S. Title 41, Chapter 6, pursuant to Laws 1997, Ch. 300, § 74 (A). Exemption from A.R.S. Title 41, Chapter 6 means the Department did not submit notice of proposed rulemaking to the Secretary of State for publication in the Arizona Administrative Register; the Department did not submit these rules to the Governor's Regulatory Review Council for review and approval; and the Department was not required to hold public hearings on this Section.