TX HHS Form 5054. Application Statement

The TX HHS Form 5054, Application Statement, is a crucial document for parents or guardians of children seeking services from the Blind Children's Vocational Discovery and Development Mees (BCVDDP) program. This form helps applicants provide essential information about themselves and their child, ensuring that BCVDDP can determine eligibility and develop an effective service plan.

The application statement requires applicants to provide basic personal information, including middle name and social security number, as well as certify that they have received a copy of "Your Rights" and understand its contents. Additionally, applicants must acknowledge their understanding of the program's financial resources requirements and procedures for determining eligibility. This form is typically filled out by parents or guardians seeking services for their child.

The TX HHS Form 5054 also outlines key features and responsibilities, including the right to review and correct information about oneself, as well as the permission to collect and receive confidential information for service planning purposes. By completing this application statement, applicants can ensure that BCVDDP has the necessary information to provide effective services and support.

• The form is used by parents or guardians seeking services from the Blind Children's Vocational Discovery and Development Mees (BCVDDP) program.
• Applicants must provide basic personal information, including middle name and social security number.
• The application statement requires certification of receipt and understanding of "Your Rights" document.