TX HHS Form H4100. Money Receipt

The TX HHS Form H4100, Money Receipt, is a crucial document that helps resolve financial transactions between the Texas Health and Human Services Commission (HHS) and its recipients. This form is typically used in situations where funds are being transferred or collected from individuals or organizations.

This form requires specific information to be provided, including the date of receipt, the amount received, and the type of payment method used. The "Received By" section indicates who is responsible for receiving the payment, while the "Type Payment" field specifies whether it's a check or money order. Additionally, the form includes a space for the recipient to specify if they are subject to verification or have a balance remaining.

Key features of this form include:

• The requirement for specific payment information to be provided
• The need for verification and balance calculation
• The responsibility of the recipient to specify their account details