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472
![Form UB-106-A-FF "Weekly Claim for Unemployment Insurance (Ui) Benefits" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059900/form-ub-106-a-ff-weekly-claim-for-unemployment-insurance-ui-benefits-arizona.png "Form UB-106-A-FF "Weekly Claim for Unemployment Insurance (Ui) Benefits" - Arizona")
Form UB-106-A-FF "Weekly Claim for Unemployment Insurance (Ui) Benefits" - Arizona
Size: 235 KB
2 pages
This is an Arizona legal document needed to verify that you were unemployed during the report week and are eligible to receive Arizona Unemployment Insurance or AZUI.
![Form ETA-83 "Weekly Request for Assistance Disaster Relief Act of 1974" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059960/form-eta-83-weekly-request-for-assistance-disaster-relief-act-of-1974-arizona.png "Form ETA-83 "Weekly Request for Assistance Disaster Relief Act of 1974" - Arizona")
![Form UB-105 "Arizona Initial Claim for Unemployment Insurance" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20598/2059894/form-ub-105-arizona-initial-claim-for-unemployment-insurance-arizona.png "Form UB-105 "Arizona Initial Claim for Unemployment Insurance" - Arizona")
![Form DD-390 "Isp Strategy" - Arizona](https://data.templateroller.com/pdf_docs_html/2017/20178/2017808/form-dd-390-isp-strategy-arizona.png "Form DD-390 "Isp Strategy" - Arizona")
![Form ES-935 "Claimant's Affidavit of Federal Civilian Service, Wages, and Reason for Separation - Ucfe" - Arizona](https://data.templateroller.com/pdf_docs_html/1896/18965/1896577/form-es-935-claimant-s-affidavit-of-federal-civilian-service-wages-and-reason-for-separation-ucfe-arizona.png "Form ES-935 "Claimant's Affidavit of Federal Civilian Service, Wages, and Reason for Separation - Ucfe" - Arizona")
![Form UC-522 "Adjustment Report" - Arizona](https://data.templateroller.com/pdf_docs_html/1896/18966/1896609/form-uc-522-adjustment-report-arizona.png "Form UC-522 "Adjustment Report" - Arizona")
![Form CC-228 "Self-employment Budget Record" - Arizona](https://data.templateroller.com/pdf_docs_html/1769/17690/1769016/form-cc-228-self-employment-budget-record-arizona.png "Form CC-228 "Self-employment Budget Record" - Arizona")
![Form CC-041 "Fair Hearing Request" - Arizona](https://data.templateroller.com/pdf_docs_html/1896/18965/1896596/form-cc-041-fair-hearing-request-arizona.png "Form CC-041 "Fair Hearing Request" - Arizona")
![Form DDD-281 "Adult Developmental Home Agreement" - Arizona](https://data.templateroller.com/pdf_docs_html/1742/17429/1742970/ddd-form-281-adult-developmental-home-agreement-arizona.png "Form DDD-281 "Adult Developmental Home Agreement" - Arizona")
![Form DDD-289 "Child Developmental Foster Home Agreement" - Arizona](https://data.templateroller.com/pdf_docs_html/1742/17429/1742988/ddd-form-289-child-developmental-foster-home-agreement-arizona.png "Form DDD-289 "Child Developmental Foster Home Agreement" - Arizona")
![Form ETA-081 "Initial Application for Disaster Unemployment Assistance" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059962/form-eta-081-initial-application-for-disaster-unemployment-assistance-arizona.png "Form ETA-081 "Initial Application for Disaster Unemployment Assistance" - Arizona")
![Form UC-514 "Report of Changes Form" - Arizona](https://data.templateroller.com/pdf_docs_html/1736/17364/1736455/form-uc-514-report-changes-form-arizona.png "Form UC-514 "Report of Changes Form" - Arizona")
![Form UB-113 "Combined-Wage Claim Withdrawal" - Arizona](https://data.templateroller.com/pdf_docs_html/1736/17364/1736456/form-ub-113-combined-wage-claim-withdrawal-arizona.png "Form UB-113 "Combined-Wage Claim Withdrawal" - Arizona")
![Form CS-124 "Application for IV-D Services/Genetic Testing Agreement" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/1349/13492/1349264/form-cs-124-application-for-iv-d-services-genetic-testing-agreement-arizona-english-spanish.png "Form CS-124 "Application for IV-D Services/Genetic Testing Agreement" - Arizona (English/Spanish)")
![Form UB-433 "Voluntary Election for Federal/State Income Tax Withholding" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/1345/13452/1345218/form-ub-433-voluntary-election-for-federal-state-income-tax-withholding-arizona-english-spanish.png "Form UB-433 "Voluntary Election for Federal/State Income Tax Withholding" - Arizona (English/Spanish)")
![Form UB-107 "Wage Statement" - Arizona](https://data.templateroller.com/pdf_docs_html/2049/20496/2049637/form-ub-107-wage-statement-arizona.png "Form UB-107 "Wage Statement" - Arizona")
![Form AG-095 "Arizona Standardized Client Assessment Plan (Ascap)" - Arizona](https://data.templateroller.com/pdf_docs_html/1342/13426/1342682/form-ag-095-arizona-standardized-client-assessment-plan-ascap-arizona.png "Form AG-095 "Arizona Standardized Client Assessment Plan (Ascap)" - Arizona")
![Form CS-258 "Affidavit of Paternity Rescission" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/1343/13433/1343323/form-cs-258-affidavit-of-paternity-rescission-arizona-english-spanish.png "Form CS-258 "Affidavit of Paternity Rescission" - Arizona (English/Spanish)")
![Form CC-208 "Provider/Parent/Guardian's Agreement for Child Care Charges" - Arizona](https://data.templateroller.com/pdf_docs_html/2061/20615/2061537/form-cc-208-provider-parent-guardian-s-agreement-for-child-care-charges-arizona.png "Form CC-208 "Provider/Parent/Guardian's Agreement for Child Care Charges" - Arizona")
![Form UC-247 "Application and Agreement for Severable Portion Experience Rating Transfer" - Arizona](https://data.templateroller.com/pdf_docs_html/1731/17314/1731498/form-uc-247-application-and-agreement-severable-portion-experience-rating-transfer-arizona.png "Form UC-247 "Application and Agreement for Severable Portion Experience Rating Transfer" - Arizona")
![Formulario FAA-001A "Solicitud De Bene Ficios" - Arizona (Spanish)](https://data.templateroller.com/pdf_docs_html/2049/20493/2049355/formulario-faa-001a-solicitud-de-bene-ficios-arizona-spanish.png "Formulario FAA-001A "Solicitud De Bene Ficios" - Arizona (Spanish)")
![Form FA-559A "Food Distribution Program Participation" - Arizona](https://data.templateroller.com/pdf_docs_html/2017/20177/2017798/form-fa-559a-food-distribution-program-participation-arizona.png "Form FA-559A "Food Distribution Program Participation" - Arizona")
![Formulario ETA-83-S "Solicitud Semanal De Assistencia Ley De Ayuda En Desastres De 1974" - Arizona (Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059961/formulario-eta-83-s-solicitud-semanal-de-assistencia-ley-de-ayuda-en-desastres-de-1974-arizona-spanish.png "Formulario ETA-83-S "Solicitud Semanal De Assistencia Ley De Ayuda En Desastres De 1974" - Arizona (Spanish)")
![Form DD-099C "Pre-pas Screening Tool Only for Members Between 6 and 11 Years Old" - Arizona](https://data.templateroller.com/pdf_docs_html/1736/17364/1736464/form-dd-099c-pre-pas-screening-tool-only-members-between-6-and-11-years-old-arizona.png "Form DD-099C "Pre-pas Screening Tool Only for Members Between 6 and 11 Years Old" - Arizona")
![Form DD-099B "Pre-pas Screening Tool for Members at Least 2 Years 10 Months Old, but Less Than 6 Years Old" - Arizona](https://data.templateroller.com/pdf_docs_html/1736/17364/1736465/form-dd-099b-pre-pas-screening-tool-members-at-least-2-years-10-months-old-but-less-than-6-years-old-arizona.png "Form DD-099B "Pre-pas Screening Tool for Members at Least 2 Years 10 Months Old, but Less Than 6 Years Old" - Arizona")
![Formulario UB-105-S "Reclamo Inicial Para Seguro Por Desempleo En Arizona" - Arizona (Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20598/2059895/formulario-ub-105-s-reclamo-inicial-para-seguro-por-desempleo-en-arizona-arizona-spanish.png "Formulario UB-105-S "Reclamo Inicial Para Seguro Por Desempleo En Arizona" - Arizona (Spanish)")
![Form CSE-1160A "Request to Close Child Support Case" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059905/form-cse-1160a-request-to-close-child-support-case-arizona-english-spanish.png "Form CSE-1160A "Request to Close Child Support Case" - Arizona (English/Spanish)")
![Formulario CCA-1212A "Puesto De Servicio Directo (Formulario De Certificacion)" - Arizona (Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059901/formulario-cca-1212a-puesto-de-servicio-directo-formulario-de-certificacion-arizona-spanish.png "Formulario CCA-1212A "Puesto De Servicio Directo (Formulario De Certificacion)" - Arizona (Spanish)")
![Form FAA-1530A "Abawd Participation and Referral Notice" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20598/2059893/form-faa-1530a-abawd-participation-and-referral-notice-arizona.png "Form FAA-1530A "Abawd Participation and Referral Notice" - Arizona")
![Form CSE-1016A "Waiver of Paternity Affidavit" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059907/form-cse-1016a-waiver-of-paternity-affidavit-arizona-english-spanish.png "Form CSE-1016A "Waiver of Paternity Affidavit" - Arizona (English/Spanish)")
![Form LCR-1054A "Initial Application Worksheet" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20598/2059897/form-lcr-1054a-initial-application-worksheet-arizona.png "Form LCR-1054A "Initial Application Worksheet" - Arizona")
![Form HRP-1013A "The Emergency Food Assistance Program (Tefap) Household Distribution Site Sign-In Sheet" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059902/form-hrp-1013a-the-emergency-food-assistance-program-tefap-household-distribution-site-sign-in-sheet-arizona-english-spanish.png "Form HRP-1013A "The Emergency Food Assistance Program (Tefap) Household Distribution Site Sign-In Sheet" - Arizona (English/Spanish)")
![Form CCA-1212A "Direct Service Position (Certification Form)" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059906/form-cca-1212a-direct-service-position-certification-form-arizona.png "Form CCA-1212A "Direct Service Position (Certification Form)" - Arizona")
![Form CSE-1185A "Affidavit of Credible Person Identifying Affiant" - Arizona (English/Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059909/form-cse-1185a-affidavit-of-credible-person-identifying-affiant-arizona-english-spanish.png "Form CSE-1185A "Affidavit of Credible Person Identifying Affiant" - Arizona (English/Spanish)")
![Form FAA-0001A "Application for Benefits" - Arizona](https://data.templateroller.com/pdf_docs_html/2049/20493/2049354/form-faa-0001a-application-for-benefits-arizona.png "Form FAA-0001A "Application for Benefits" - Arizona")
![Form LCR-1033A "Life-Safety Inspection Request" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059918/form-lcr-1033a-life-safety-inspection-request-arizona.png "Form LCR-1033A "Life-Safety Inspection Request" - Arizona")
![Form FAA-1475A "Verification of out-Of-State Benefits" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059923/form-faa-1475a-verification-of-out-of-state-benefits-arizona.png "Form FAA-1475A "Verification of out-Of-State Benefits" - Arizona")
![Form FAA-1111A "Participant Statement Verification Worksheet" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059912/form-faa-1111a-participant-statement-verification-worksheet-arizona.png "Form FAA-1111A "Participant Statement Verification Worksheet" - Arizona")
![Formulario FAA-1111A "Formulario Para Verificar La Declaracion Del Participante" - Arizona (Spanish)](https://data.templateroller.com/pdf_docs_html/2059/20599/2059913/formulario-faa-1111a-formulario-para-verificar-la-declaracion-del-participante-arizona-spanish.png "Formulario FAA-1111A "Formulario Para Verificar La Declaracion Del Participante" - Arizona (Spanish)")
![Form CSE-1168A "Agreement to Accept Service by Mail - TANF Workshops" - Arizona](https://data.templateroller.com/pdf_docs_html/2059/20599/2059904/form-cse-1168a-agreement-to-accept-service-by-mail-tanf-workshops-arizona.png "Form CSE-1168A "Agreement to Accept Service by Mail - TANF Workshops" - Arizona")
