TX HHS Form H1239. Request for Verification of Bank Accounts

The TX HHS Form H1239, Request for Verification of Bank Accounts, is a crucial document that helps facilitate the verification process for medical assistance applications. This form is typically completed by individuals being considered for medical assistance programs and serves as a means to provide accurate information about their bank accounts.

This form requires the submission of specific details, including the name and address of the bank, insurance company, and eligibility specialist. Additionally, it asks for information about any additional accounts that may have access, such as IRAs, CDs, or safety deposit boxes. The form also requests a breakdown of account balances as of specific dates, along with information on whether any accounts have been closed.

To complete this form, individuals must provide the required information and follow the instructions outlined in the document. Key points to note include:

• The need for accurate and up-to-date information about bank accounts
• The requirement to disclose any additional accounts that may have access
• The importance of verifying account balances as of specific dates
• The possibility of closing an account, which requires completing the relevant sections on the form