TX HHS Form H3034. Disability Determination Socio-Economic Report
Form H3034, titled Disability Determination Socio-Economic Report, is a Texas Health and Human Services Commission (HHSC) document used to collect personal, educational, employment, and background information as part of a disability-related eligibility review.
TX HHS Form H1049. Client's Statement of Self-Employment Income
Form H1049, titled Facts About Self-Employment Income, is used by the Texas Health and Human Services Commission (HHSC) to collect detailed information about income earned from self-employment.
TX HHS Form 0007. Notification of County Jail Confinement and Release
Form 0007, titled “Notification of County Jail Confinement and Release”, is an official Texas Health and Human Services Commission (HHSC) form used by county jails to report when an individual receiving HHSC health care coverage is confined or released.
TX HHS Form H1138. Living Arrangement Verification
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.
TX HHS Form H1009. TANF or SNAP Benefits Notice of Eligibility
Form H1009 is an official notice issued by the Texas Health and Human Services Commission (HHSC) to inform applicants and recipients about their eligibility for Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) benefits.
TX HHS Form 5873. Waiver and Community-based Programs and Services - Medicaid and CHIP Services Contract Application Packet Checklist
Form 5873 is an official checklist used in Texas during the application process for provisional contracts under Waiver and Community-based Programs and Services for Medicaid and CHIP.
TX HHS Form 8615. On-site and Off-site Individualized Skills and Socialization Service Delivery Log
Form 8615 is an official service documentation form used in Texas for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs. It serves as a detailed delivery log for Individualized Skills and Socialization services provided both on-site and off-site.
TX HHS Form H2060-A. Addendum to Form H2060
Form H2060-A is an official Texas Health and Human Services Commission (HHSC) document used as an addendum to Form H2060. It is designed to identify and authorize additional Personal Assistance Services (PAS) hours that were not fully captured in the original needs assessment.
Form MCSA-5871. Vision Evaluation Report
The MCSA-5871 Vision Evaluation Report is a mandatory form used by the Federal Motor Carrier Safety Administration (FMCSA) to assess whether individuals meet the vision standards required to operate commercial motor vehicles in interstate commerce.
Pennsylvania Department of Transportation Forms
Pennsylvania has a wide range of forms related to driver's licenses, identification cards, and vehicle registration.