Exhibit H - List of Vital Documents - AUG 2018 Updated 2018

Sep 16, 2026

Uploaded by Angel

Exhibit H compiles a comprehensive inventory of vital forms, notices, and application packets used across multiple departments. The listing spans finance and compliance items, business licensing and related questionnaires, property and tax documents, permits and inspection notices, and fire-related certificates and guidelines. It also includes human services and justice program paperwork such as release of information forms, agreements, case management reports, and ADA accommodation requests. Many documents are referenced with Spanish translations for multilingual client use, supporting standardized submissions and ongoing program administration throughout 2017 and updated 2018.

LanguageEnglish

CategoryForms

FormatPDF

Pages14

Reading Time5 min

AccessFree to download

Department Sections

Finance

Fire

OMBD

Consent and Release of Information (Dept. of Consent for Release of Information)

Human ADA Accommodation

DSS CSA Parental Agreement Template

Department [No. name](No. name) [1.- Finance](1.- Finance) [2.- Fire](2.- Fire) 3.- OMBD Name of the document 2017 Application Form 2017 Application Page (Filing deadline) New Applicant Letter Recertification Rescind Letter Recertification Form Tax Relief Brochure Tax Relief Denial Tax Relief Request ALM_coupon BPOL Questionnaire Business License Application Business License Checklist Business License Incentive Application Business_Lic_Spnish_BPOL_Instructions Tangible Personal Property Daily Rental Application Daily Rental Quarterly Electronic Copy of BPOL Questionnaire Escrow Application Back Escrow Application Front MachineryAndToolsTaxReturn No Documentation Letter Pen and Int Waiver Back Pen and Int Waiver Front PP_High mileage instructions PP_High mileage TACS and Ballato info Cards Tax Information Back Tax Information Front TaxReliefAuthorizationForm Vendor's packet Contractor cart Permit Application Stop Work Order Inspection Notice Fire Marshal's Office Certificate Permit Holder Guideline Language Access Request Forms Emerging Small Business (ESB) Registration Checklist Minority Business Development Registration Checklist MBE/ESB Change in Subcontractors Form MBE/ESB Past Good Faith Efforts Participation Form MONTHLY COMPLIANCE REPORT (MBE-3) MBE/ESB PARTICIPATION FORM (MBE-2) Good-Faith Minority Business Enterprise and Emerging Small Business Participation Efforts Documentation of Contacts Contractor Assistance Loan Program 4.- Dept. of Consent for Release of Information Justice Serv. Probation Supervision Agreement Division of Adult Program Intake Packet Random Drug Testing Form Color Change Form Program Brochure Consent for release of Information Supervision Agreement Fee Agreement Adult Day Reporting Release of Information Dress Code Client Case Management Report Attendance policy Behavior Contract Client Agreement Code of Conduct Replacement Book Contract Family Ties Grievance Form-Juvenile Programs Behavioral Health Docket Community Service Work Evening Reporting Center 5.- Human ADA Accommodation Form Resources ADA Discrimination Form CDL Employment Application Form & Release Form Consent to Release Information Form Emergency Contact Form Random Notification Form Reasonable Suspicion Notification Form Reasonable Suspicion- Incident Documentation Form Post Accident Form Violence Report Form 6.- DSS CSA Parental Agreement Template Economic Support & Independence Division Vital Documents already translated into Spanish: Consent to Exchange Information (Spanish) Confidentiality Agreement (Spanish) SNAPET Pre-Assessment (Spanish) SNAPET Plan of Participation (Spanish) SNAPET Job Search (Spanish) SNAPET Notice of Case Closure (Spanish VIEW Job Search (Spanish) Activity and Service Plan (Spanish – Fillable) VIEW Assessment (Spanish) VIEW Notice of Sanction/Termination (Spanish) VIEW Agreement of Personal Responsibility (Spanish) Do You Have a Disability? (Spanish) Multilingual Client Notice (Spanish) Medicaid Notice of Action (Spanish) Advance Notice of Proposed Action (Spanish) Statement of Required Presence of Caregiver (Spanish) Medical Expense Record (Spanish) Notice of Cooperation & Good Cause (Spanish) Appeal to the State Department of Social Services (Spanish) Authorization for Release of SSI Check (Spanish) Notice of Change Report (Spanish) Application/Redetermination for Medicaid for SSI Recipients (Spanish) Notice of Action (SNAP) (Spanish) Request for Contact (Spanish) Entitlement to Restoration of Lost Benefits (Spanish) SNAP Sanction Notice for Noncompliance with a Work Requirement (Spanish) Families & Children Medicaid & FAMIS Plus Renewal (Spanish) Returned TANF Debit Cards (EPPICards) (Spanish) Notification of Change (Spanish) Affidavit of Identity for Medicaid Applicants and Recipients Under Age 16 (Spanish) Acceptance Terms of Issuance for

FAQs

What document types are included in Exhibit H?

Exhibit H lists application forms, questionnaires, letters, checklists, agreements, notices, reports, and related vital document packets across departments.

Which departments and program areas are covered by the document list?

The list includes finance, fire, OMBD, consent and release of information, human ADA accommodation, and DSS/CSA materials, along with multiple service and reporting sections.

Are Spanish translations included in the vital document list?

Yes. The inventory explicitly notes that many vital documents are already translated into Spanish and grouped by program areas for multilingual client use.

Sep 16, 2026

Uploaded by Angel