SNAP, Health Care, and TEA-RCA Application Form
| Title | Type | Posted Date |
|---|---|---|
| Application for SNAP, Health Care, and TEA-RCA (multi-program application) – English | 12/03/2020 | |
| Application for SNAP, Health Care, and TEA-RCA (multi-program application) – Spanish | 12/03/2020 | |
| 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 | 11/30/2018 | |
| Medicare Savings Application – Spanish | 11/30/2018 | |
| Medicaid Change Report | ||
| Quick Reference Medicaid Chart 2021 | 04/28/2021 | |
| Income Trust Form | 11/30/2018 | |
| Income Trust Fact Sheet | 11/30/2018 | |
| Your Guide To Medicaid Estate Recovery In Arkansas | 01/30/2018 |
SNAP Forms & Documents
Transitional Employment Assistance / Refugee Cash Assistance Forms & Documents
| Title | Type | Posted Date |
|---|---|---|
| Transitional Employment Assistance / Refugee Cash Assistance Forms & Documents | ||
| TEA Change Report |
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 |
