| Form H0003, Agreement to Release Your FactsES |
| Form H0004, Consent for a Person Sponsoring an ImmigrantES |
| Form H0005, Policy Clarification Request (PCR) |
| Form H0011, Texas Simplified Application Project (TSAP) for SNAP Food BenefitsES |
| Form H0011-R, Texas Simplified Application Project (TSAP) for SNAP Food Benefits RenewalES |
| Form H0050, Parent Profile QuestionnaireES |
| Form H0070, Food Stamps Streamlined Reporting (Income Calculation Worksheet) |
| Form H0599, SNAP Expungement NoticeES |
| Form H0901, HHSC Enhanced Data Gathering Worksheet |
| Form H0920, Notice from the Community Organization Helping YouES |
| Form H0926, Sharing Facts About Me and My Case with a Community Partner ES |
| Form H1003, Appointment of an Authorized Representative to Allow Another Person to Act for YouES |
| Form H1004, Cover Letter – Authorized Representative Not VerifiedES |
| Form H1008-A, Warrant Inquiry and EBT Benefit Conversion and Affidavit for Non-receipt of Warrant |
| Form H1009, TANF or SNAP Benefits Notice of Eligibility |
| Form H1010, Texas Works Application for Assistance – Your Texas BenefitsES |
| Form H1010-MR, MAGI Renewal AddendumES |
| Form H1010-R, Your Texas Works Benefits – Renewal FormES |
| Form H1012, Immunization Record |
| Form H1013, Electronic Correspondence Confirmation LetterES |
| Form H1014-A, Children's Health Care Benefits – Final ReminderES |
| Form H1015, Electronic Correspondence Failed DeliveryES |
| Form H1016, Supplemental Security Income Referral |
| Form H1017, Notice of Benefit Denial or ReductionES |
| Form H1017-B, Transitional MedicaidES |
| Form H1017-P, Notice of Benefit Denial and Personal Responsibility Agreement (PRA) ReasonsES |
| Form H1018, Overpayment Claim |
| Form H1019, Report of ChangeES |
| Form H1019-F, Reporting Changes to Your CaseES |
| Form H1020, Request for Information or ActionES |
| Form H1020-A, Sources of ProofES |
| Form H1021, Payment Agreement – Verbal Authorization for One-Time Debit of an Active Lone Star Food Account |
| Form H1024, Subject – Self-Declaration NoticeES |
| Form H1026, Verification of Railroad Retirement Benefits |
| Form H1026-FTI, Verification of Railroad Retirement Benefits |
| Form H1027-A, Medicaid Eligibility Verification |
| Form H1027-B, Medicaid Eligibility Verification - MQMB |
| Form H1027-C, Medicaid Eligibility Verification - QMB |
| Form H1027-F, Proof of Health Care Coverage |
| Form H1028, Employment VerificationES |
| Form H1029, Notice of Case Action |
| Form H1030, Supplemental Nutrition Assistance Program (SNAP) Lone Star Card AssistanceES |
| Form H1036, Refugee Cash Assistance Verification Form |
| Form H1038, Medical Facility Referral |
| Form H1039, Medical Insurance Input |
| Form H1040-A, Application Suspense File Card |
| Form H1040-B, Review Suspense File Card |
| Form H1040-C, Change Suspense File Card |
| Form H1041, Worker Activity Log |
| Form H1042, Modified Adjusted Gross Income (MAGI) Worksheet |
| Form H1044, Standby Log |
| Form H1046, Inpatient Medical Services CertificationES |
| Form H1049, Client's Statement of Self-Employment IncomeES |
| Form H1049-3, Self-Employment Income Worksheet |
| Form H1050, Check Verification |
| Form H1057, Declaration of Informal MarriageES |
| Form H1059, Interview Observation Instrument |
| Form H1060, Case Preparation Guide |
| Form H1061, Birth Outcome LetterES |
| Form H1062, Birth Outcome Reminder LetterES |
| Form H1063, Request for Review Outcome LetterES |
| Form H1064, CHIP Continued Enrollment LetterES |
| Form H1065, Tuition and Fee Exception Letter |
| Form H1071, Family Violence Exemption for Medicaid and CHIPES |
| Form H1072, One Time Temporary Assistance for Needy Families AcknowledgementES |
| Form H1073, Personal Responsibility AgreementES |
| Form H1074, SNAP Force Change Request |
| Form H1076-A, Notice of TANF State Time Limits |
| Form H1076-B, Notice of TANF State Time Limit Months Used/Changed/Corrected |
| Form H1076-C, Notice of End of TANF State Time Limit/Hardship Exemption |
| Form H1077, Notice of TANF Federal Time LimitsES |
| Form H1079, Qualifying Quarters of Social Security Earnings |
| Form H1084, Certification for Warrants Lost, Destroyed, Stolen or Not ReceivedES |
| Form H1086, School Attendance Verification |
| Form H1087, Verification of Texas Health Steps Checkup |
| Form H1088, Verification of Parenting Skills TrainingES |
| Form H1093, Texas Health Steps Extra Effort Referral |
| Form H1094, Notice of TANF-SP Time LimitES |
| Form H1095, Treatment Facility Fraud Referral |
| Form H1096, Notification LetterES |
| Form H1097, Affidavit for Citizenship/IdentityES |
| Form H1100, Addendum Income Worksheet |
| Form H1101, TANF Worksheet |
| Form H1102, TANF Worksheet for Special Reviews and Denials |
| Form H1103, Verification of TANF EligibilityES |
| Form H1104, 90% Earned Income Deduction (EID) Eligibility and Tracking |
| Form H1105, SNAP Expedited Screening Sheet |
| Form H1106, Enumeration ReferralES |
| Form H1106-A, Proofs You Need to Apply for a Social Security Number Card |
| Form H1107, Request for Forced Change of Medical Coverage |
| Form H1111, Card Order Discrepancy Verification |
| Form H1113, Application for Prior Medicaid CoverageES |
| Form H1119, Medical Programs Income Worksheet |
| Form H1120, Medical Bills TransmittalES |
| Form H1122, Medicaid Action NoticeES |
| Form H1131, Individually Identifiable Health Information Fax Transmittal |
| Form H1134, Help Statement VerificationES |
| Form H1135, Child Care Expense VerificationES |
| Form H1136, Child Support VerificationES |
| Form H1137, Confirmation of Office Visit Work/School ExcuseES |
| Form H1138, Living Arrangement Verification |
| Form H1139, Medical Expense Verification |
| Form H1140, Verification of BenefitsES |
| Form H1146-M, Medicaid Report (Manual)ES |
| Form H1155, Request for Domicile VerificationES |
| Form H1163, TWC Employment Registration |
| Form H1172, EBT Card, PIN and Data Entry RequestES |
| Form H1173, EBT Card Issuance Log |
| Form H1174, Inventory of EBT Cards |
| Form H1175, EBT Change Request |
| Form H1177, Transmittal and Receipt for Controlled EBT Documents |
| Form H1184, Here is Your Lone Star CardES |
| Form H1185, Important Information About Your Lone Star CardES |
| Form H1187, Welcome to Texas Health Steps Medicaid! |
| Form H1188, Common Questions Asked About Texas Health Steps and Your Child's Medicaid |
| Form H1190, Ending TANF Five Year Freeze Out Disqualification |
| Form H1205, Texas Streamlined ApplicationES |
| Form H1213, Children’s Health-Care Benefits – More Facts Needed from the Parent Who Has CustodyES |
| Form H1240, Request for Information from Bureau of Veterans Affairs and Client's Authorization |
| Form H1265, Presumptive Eligibility (PE) WorksheetES |
| Form H1266, Short-term Medicaid Notice – ApprovedES |
| Form H1267, Short-term Medicaid Notice – Not ApprovedES |
| Form H1350, Opportunity to Register to Vote |
| Form H1550, Out of State NBCCEDP Verification |
| Form H1551, Treatment VerificationES |
| Form H1701, Child Support, TANF Foster Care and TANF/Medicaid Case Information Exchange |
| Form H1706, Good Cause Recommendation and Family Violence Exemption |
| Form H1708-A, Report of Noncooperation – Automated |
| Form H1710, Payment IdentificationES |
| Form H1713, Acknowledgement of Family Violence Good Cause Option and Contact ResourcesES |
| Form H1800, Receipt for Application, Medicaid Report, Verification or Report of ChangeES |
| Form H1801, SNAP Worksheet |
| Form H1802, Voluntary Withdrawal from Temporary Assistance for Needy Families (TANF) |
| Form H1805, SNAP Food Benefits – Your Rights and Program RulesES |
| Form H1806, Parole or Community Supervision ReportES |
| Form H1808, Agreement to Follow SNAP Work RulesES |
| Form H1816, SNAP Employment and Training Noncompliance Report |
| Form H1817, SNAP Information Transmittal |
| Form H1822, ABAWD Employment and Training Work Requirement Verification |
| Form H1825, Entitlement to Restored BenefitsES |
| Form H1826, Case Information ReleaseES |
| Form H1830, Application, Review, Expiration or Appointment NoticeES |
| Form H1830-I, Interview Notice – Applications or Reviews |
| Form H1830-R, Texas Works Renewal NoticeES |
| Form H1832, Affidavit for Meal Providers to the Homeless |
| Form H1833, Your Medicaid Benefits Are Ending – Cover LetterES |
| Form H1833-L, Your Medicaid Benefits Are EndingES |
| Form H1834, Your Medicaid Benefits Have Ended - Cover LetterES |
| Form H1834-L, Your Medicaid Benefits Have EndedES |
| Form H1836-A, Medical Release and Physician's StatementES |
| Form H1836-B, Medical Release or Physician's StatementES |
| Form H1837, Physician's Statement of Permanent Disability |
| Form H1841, SNAP-CAP ApplicationES |
| Form H1842, SNAP-CAP Renewal ApplicationES |
| Form H1843, Your SNAP-CAP Food Benefits Have Changed |
| Form H1845, Drug and Alcohol Treatment (D&A) and Group Living Arrangement (GLA) Facility Review |
| Form H1846, Facility Authorized Representative Interview |
| Form H1847, Reminder to Submit Form H1852 |
| Form H1851, Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities |
| Form H1852, List of Resident Participants in the Supplemental Nutrition Assistance Program (SNAP)ES |
| Form H1853, Documentation of Findings for Form H1852 |
| Form H1854, Affidavit for Unauthorized Use of Electronic Benefit Transfer (EBT) Benefits |
| Form H1855, Affidavit for Nonreceipt or Destroyed Supplemental Nutrition Assistance Program (SNAP) BenefitsES |
| Form H1856, SNAP Out-of-State Intentional Program Violations |
| Form H1857, Landlord VerificationES |
| Form H1858, Items We Might Need from Anyone on Your CaseES |
| Form H1861, Federal Tax Information Record Keeping and Destruction Log |
| Form H1862, Federal Tax Information Transmittal Memorandum |
| Form H1863, Federal Tax Information Removal Log |
| Form H1864, Federal Tax Information Fax Transmittal |
| Form H1866, Federal Tax Information Visitor Access LogES |
| Form H1869, Renewal for Health Care BenefitsES |
| Form H1870, School Enrollment Verification FormES |
| Form H1898, Restored Benefits Documentation |
| Form H1899, Unauthorized Use Replacement Benefit Eligibility Notice |
| Form H1901, TIERS Data Collection Worksheet |
| Form H2067, Case Information |
| Form H2340-OS, Medicaid for Breast and Cervical Cancer |
| Form H2580, TANF Employment Services Notice |
| Form H2583, Choices Information Transmittal |
| Form H2588, Workforce Orientation Referral |
| Form H2776, Job Search Worksheet for TANF Employment Hardship ExemptionES |
| Form H3037, Report of PregnancyES |
| Form H3038, Emergency Medical Services CertificationES |
| Form H3038-P, CHIP Perinatal - Emergency Medical Services CertificationES |
| Form H4100, Money ReceiptES |
| Form H4701, HHSC Out Card |
| Form H4800, Fair Hearing Request Summary |
| Form H4800-A, Fair Hearing Request Summary (Addendum) |
| Form H4803, Notice of HearingES |
| Form H4837, Fair Hearings Evidence Packet Cover LetterES |
| Form H4857, Notice of Decision, Administrative Disqualification Hearing |
| Form H5799, TANF Warrant or Envelope |
| Form HRG-83, SSN Maintenance MemorandumES |
| Form SCR, Secondary Cardholder Request |
| Form SSA-2853, Message From Social Security |
| Form SSA-3288, Social Security Administration Consent for Release of Information |
| VR30, Texas Voter Registration ApplicationES |
