SNAP, Health Care, and TEA-RCA Application Form
| Title | Type | Posted Date |
|---|---|---|
| Application for SNAP, Health Care, and TEA-RCA (multi-program application) – English | 08/16/2024 | |
| Application for SNAP, Health Care, and TEA-RCA (multi-program application) – Spanish | 09/01/2022 | |
| Application for SNAP, Health Care, and TEA-RCA (multi-program application) – Marshallese | 12/03/2020 |
Health Care Forms & Documents
| Title | Type | Posted Date |
|---|---|---|
| Form 1095-B: Health Coverage | LINK | 01/12/2021 |
| Medicare Savings Application | 08/16/2024 | |
| Medicare Savings Application – Spanish | 09/30/2022 | |
| Medicaid Change Report | ||
| Quick Reference Medicaid Chart 2024 | 04/01/2024 | |
| Income Trust Form | 07/01/2022 | |
| Income Trust Fact Sheet | 07/01/2022 | |
| Your Guide To Medicaid Estate Recovery In Arkansas | 01/30/2018 |
SNAP Forms & Documents
| Title | Type | Posted Date |
|---|---|---|
| SNAP Forms & Documents | ||
| Access Arkansas Online Applications for SNAP | WEB | |
| SNAP Quick Reference Guide | 10/01/2024 | |
| SNAP Change Report | ||
| Electronic Benefits Transfer Card Information | LINK | |
| Smart Nutrition Active People-Education | SNAP-ED| | LINK | |
| SNAP Employment and Training Counties | ||
| SNAP Farmer’s Markets | ||
| SNAP Double Up Food Dollars | ||
| SNAP Double Up Food Bucks – How It Works | LINK | |
| SNAP non-discrimination statement (Spanish) | ||
| EBT Training Pamphlet | Spanish | ||
| EBT Training Pamphlet | English |
Transitional Employment Assistance / Refugee Cash Assistance Forms & Documents
| Title | Type | Posted Date |
|---|---|---|
| Transitional Employment Assistance / Refugee Cash Assistance Forms & Documents | ||
| TEA Change Report | ||
| TEA Application | 8/2024 | |
| TEA Quick Reference Guide 2024 | 4/2024 |
Community Services Grants Programs Forms & Documents
| Title | Type | Posted Date |
|---|---|---|
| Community Services Grants Programs Forms & Documents | ||
| Arkansas Community Action Agencies 2020 | 09/21/2020 | |
| Emergency Solutions Grant COVID-19 Subgrantee Contact List | 10/13/2020 | |
| Emergency Solution Grant Subgrantee Contact List | 09/21/2020 |
