Formulario DDD-1658A-S Agency With Choice: Representante Individual - Arizona (Spanish)

Qué es Formulario DDD-1658A-S?

Este es un formulario legal que fue publicado por el Arizona Department of Economic Security, una autoridad gubernamental que opera dentro de Arizona. A partir de hoy, el departamento emisor no proporciona en separado pautas de presentación para el formulario.

Detalles del formulario:

• Publicado el 1 de febrero de 2023;
• La última versión proporcionada por el Arizona Department of Economic Security;
• Lista para utilizar e imprimir;
• Fácil de personalizar;
• Compatible con la mayoría de las aplicaciones para visualizar PDF;
• Complete este formulario en línea.

Descargue una versión del Formulario DDD-1658A-S haciendo clic en el enlace debajo o busque más documentos y plantillas proporcionados por el Arizona Department of Economic Security.

FAQ

Q: What is the DDD-1658A-S form?
A: The DDD-1658A-S form is a form used for Agency With Choice: Individual Representative in Arizona.

Q: What is Agency With Choice?
A: Agency With Choice is a program that allows individuals with disabilities to select their own caregivers and manage their own services.

Q: What is a Representante Individual?
A: A Representante Individual is an Individual Representative who helps individuals with disabilities to select their own caregivers and manage their own services in the Agency With Choice program.

Q: What is the purpose of the DDD-1658A-S form?
A: The purpose of the DDD-1658A-S form is to designate a Representante Individual.

Q: Who can complete the DDD-1658A-S form?
A: The individual with a disability or their legal guardian can complete the DDD-1658A-S form.

Q: What information is required on the DDD-1658A-S form?
A: The DDD-1658A-S form requires the individual's name, date of birth, mailing address, and the name and contact information of the designated Representante Individual.

Q: Is there a fee to submit the DDD-1658A-S form?
A: No, there is no fee to submit the DDD-1658A-S form.

Q: Can the DDD-1658A-S form be submitted electronically?
A: Yes, the DDD-1658A-S form can be submitted electronically.

Q: What if I need assistance completing the DDD-1658A-S form?
A: If you need assistance completing the DDD-1658A-S form, you can contact the Division of Developmental Disabilities (DDD) for assistance.