TX HHS Form 4103. Vendor Invoice Summary

The TX HHS Form 4103, Vendor Invoice Summary, is a crucial document for vendors to summarize their invoices and provide essential information to Texas Health and Human Services (HHS). This form helps solve the problem of tracking and processing vendor invoices efficiently. It should be used when submitting an invoice to HHSC.

The form requires key information such as the invoice date, number, vendor ID (TIN or EIN), name, gross amount, purchase order (PO) number, and contract details. Vendors must complete a separate form for each invoice, ensuring that invoices are not combined. The "Return this form with your invoice" instruction emphasizes the importance of submitting the completed form along with the invoice to [email protected].

The HHSC Internal Use Only section indicates that the form is intended for internal use only, suggesting that it may contain sensitive or confidential information. By following these guidelines and completing the Vendor Invoice Summary form accurately, vendors can facilitate a smooth invoicing process with Texas HHS (TX HHS Form 4103: Vendor Invoice Summary).