TX HHS Form 3085. Statement of Self-Employment Income

The TX HHS Form 3085, "Statement of Self-Employment Income", is a crucial document for individuals who earn income through self-employment. This form helps solve the problem of accurately reporting self-employment income to the County Indigent Health Care Program (CIHCP). It should be used by individuals who have self-employment income and need to provide documentation of their earnings.

The form requires important information, including the name of the person with self-employment income, the number of months covered by the statement, a description of how the income was earned, and a list of business expenses and income. It is essential to attach receipts, invoices, or other verifying papers to support the reported income. The form also includes a section for the individual to sign and date, acknowledging that the information provided is true, correct, and complete.

This form is particularly useful in scenarios where individuals need to demonstrate their self-employment income as part of an application process, such as when applying for assistance through the CIHCP. It is crucial to understand that providing false information on this form can result in disqualification for fraud, emphasizing the importance of accuracy and honesty.