TX HHS Form H1173. EBT Card Issuance Log

The TX HHS Form H1173, EBT Card Issuance Log, is a crucial document for tracking the issuance of Electronic Benefits Transfer (EBT) cards. This form helps solve the problem of accurately recording and monitoring the distribution of EBT cards to eligible recipients.

This log requires essential information such as the name of the card, PIN, self-replacement date, primary cardholder's card number (PAN), and recipient selection. The signature of the recipient serves as a confirmation that they have received the EBT card. The form is typically used in situations where EBT cards are issued to individuals or families receiving government assistance programs.

The key features of this form include the required information mentioned above, which ensures accurate tracking and monitoring of EBT card issuance. This document helps maintain accountability and transparency in the distribution process. Here are some key points to note:

• The form is used for recording EBT card issuance.
• It requires essential information such as card details, recipient selection, and signature.
• The form is typically used in situations where government assistance programs are involved.