This version of the form is not currently in use and is provided for reference only. Download this version of Form FAA-1004A-LP for the current year.
This is a legal form that was released by the Arizona Department of Economic Security - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form FAA-1004A-LP?
A: Form FAA-1004A-LP is a designation form for an alternate card holder for an EBT card in Arizona, in large print format.
Q: What is an EBT card?
A: An EBT card is an Electronic Benefit Transfer card, which is used to access government assistance programs.
Q: Who can use this form?
A: This form is for residents of Arizona who want to designate an alternate card holder for their EBT card.
Q: What does the form allow me to do?
A: The form allows you to designate someone else to use your EBT card on your behalf.
Q: What is the purpose of having an alternate card holder?
A: Having an alternate card holder can help if you are unable to use your EBT card yourself, ensuring that you can still receive government benefits.
Q: Is this form specific to Arizona?
A: Yes, this form is specific to Arizona.
Q: Is there a fee for submitting this form?
A: No, there is no fee for submitting this form.
Q: Are there any eligibility requirements to designate an alternate card holder?
A: The eligibility requirements may vary, so you should refer to the instructions on the form or contact the Arizona Department of Economic Security for more information.
Form Details:
Download a fillable version of Form FAA-1004A-LP by clicking the link below or browse more documents and templates provided by the Arizona Department of Economic Security.