Texas

The TX HHS Form H1172, EBT Card, PIN and Data Entry Request, is a crucial document for individuals seeking to request the issuance of an Electronic Benefits Transfer (EBT) card. This form helps solve the problem of obtaining a new or replacement EBT card, which is essential for recipients of government assistance programs such as Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP). The form is typically used in situations where an individual needs to request a new card due to loss, theft, or damage.

The TX HHS Form H1163, TWC Employment Registration, helps individuals who receive or will receive Temporary Assistance for Needy Families (TANF) Supplemental Program (SP) benefits to register for employment services. This form is used in situations where the individual is referred for employment registration and needs to provide required information to access these services.

Form H1155, also known as the Request for Domicile Verification, is a document used by the Texas Health and Human Services Commission (HHSC) to verify where a client actually lives and who resides with them. Although the form is brief, it plays a significant role in determining eligibility for various public assistance programs. HHSC cannot rely solely on a client’s statement when housing details are unclear, inconsistent, or require third-party confirmation — especially when the household composition affects benefits.

Form H1146-M is an official Medicaid reporting document used by the Texas Health and Human Services Commission (HHSC) for families receiving Transitional Medicaid. This form is required to report changes in household income and child care expenses in order to continue Medicaid coverage for up to 12 months after losing TANF eligibility.

Form H1140, titled Verification of Benefits, is an official document used by the Texas Health and Human Services Commission (HHSC) to confirm information about public assistance benefits received by an individual or household. This form is most commonly used to verify benefits under programs such as Temporary Assistance for Needy Families (TANF) and Food Stamps (SNAP) for specific months.

The Medical Expense Verification Form H1139 is a crucial document that helps individuals verify their out-of-pocket medical expenses to determine their eligibility for services. This form is typically filled out by clients who incur medical expenses and need assistance from the Texas Health and Human Services Commission (HHSC) to evaluate their situation.

Form H1138, titled Living Arrangement Verification, is an official document used to confirm the living situation and financial relationship between an individual applying for or receiving public assistance and the person they live with. The form helps state agencies verify whether the individual pays rent or utilities, receives financial support, or shares household expenses, which can directly affect eligibility and benefit amounts.

The TX HHS Form H1137, Confirmation of Office Visit Work/School Excuse, is a practical tool for verifying an individual's presence in a government office. This form helps solve the problem of providing proof of attendance or participation in official activities, making it essential for situations where documentation is required.

The TX HHS Form H1136, Child Support Verification, is a crucial document that helps the Texas Health and Human Services Commission accurately evaluate a household's situation. This form is typically filled out by individuals who are providing assistance for their children and need to verify their child support payments.

The TX HHS Form H1135, Child Care Expense Verification, helps solve the problem of accurately evaluating a household's situation by providing essential information about child care expenses. This form is typically used in situations where the Texas Health and Human Services Commission needs to assess a household's financial situation for the purpose of determining eligibility for certain benefits or services.