TX HHS Form H1175. EBT Change Request

The TX HHS Form H1175, EBT Change Request, is a document used to request changes to an Electronic Benefits Transfer (EBT) account. This form helps solve the problem of updating primary cardholder information when changes cannot be made through the EBT system.

This form requires key information such as the primary cardholder's name, date of birth, social security number, and mailing address. The Part I section is used to update the primary cardholder record, while Parts II and III are used for splitting or merging linked accounts. Important sections include the SNAP Priority Benefit Record and the Expedited (Timely) Form H1855 signed? fields.

The EBT Change Request form should be used when changes cannot be made through the TIERS system. This may occur due to issues with the primary cardholder record, such as incorrect information or incomplete applications. The form is a useful tool for resolving these types of issues and ensuring accurate and timely benefits distribution.