TX HHS Form H1177. Transmittal and Receipt for Controlled EBT Documents

The TX HHS Form H1177, Transmittal and Receipt for Controlled EBT Documents, is a crucial tool for managing the transmission and receipt of Lone Star cards. This form helps ensure the secure handling and tracking of these controlled documents, which are essential for various government programs.

This form is typically used in situations where Lone Star cards need to be transmitted or received by authorized personnel. The document requires information such as the number of cards being transmitted, their serial numbers, and the signatures of both the person transmitting and receiving the documents. Additionally, the form includes a section for recording the date of transmission.

Key features of this form include:

• The requirement to attach Lone Star cards with serially numbered from [starting serial number] through ending serial number]
• The need for signatures from both the person transmitting and receiving the documents
• The recording of the date of transmission