TX HHS Form H1242-FTI. Verification of Mineral Rights - FTI

The TX HHS Form H1242-FTI, Verification of Mineral Rights - FTI, is a crucial document that helps solve the problem of verifying mineral rights information for medical assistance eligibility. This form is typically used in situations where an individual or representative needs to provide fair market value and income information on specific mineral rights.

This form requires the client or representative to provide detailed information about the mineral rights, including their identity and contact details, as well as the source of verification. The undersigned client gives permission for the department to use this information to determine eligibility for medical assistance. The department cannot grant or continue eligibility without this information.

The form also includes a section for federal tax information, which must be completed by checking the appropriate box (Yes or No). Additionally, the form requests that the client or representative complete and return Page 2 of Form H1242-FTI. Key points to note include:

• Verification of mineral rights is required for medical assistance eligibility.
• The department needs this information to determine eligibility.
• The client or representative must provide fair market value and income information on the mineral rights.