TX HHS Form H1084. Certification for Warrants Lost. Destroyed. Stolen or Not Received

The TX HHS Form H1084, "Certification for Warrants Lost, Destroyed, Stolen or Not Received," is a crucial document that helps resolve issues related to missing Treasury warrants. This form is typically completed by TANF recipients who have lost, destroyed, stolen, or not received their Treasury warrants.

The form requires the recipient to provide essential information about the warrant, including the owner's mailing address and the amount of the warrant. The recipient must also certify that they are the true owner or authorized representative for the owner of the warrant, and that the information provided is true and correct. Additionally, the form outlines specific conditions and responsibilities, such as understanding that a stop payment and cancellation will take place upon receipt of the certification by Texas Health and Human Services (HHS). The recipient must also agree to return any received warrants to the local HHS office or the address shown below.

Key features of this form include:

• The requirement for the recipient to certify that they are the true owner or authorized representative for the owner of the warrant.
• The need to provide accurate and truthful information about the warrant.
• The understanding that a stop payment and cancellation will take place upon receipt of the certification by HHS.
• The responsibility to return any received warrants to the local HHS office or the address shown below.