ES = Spanish version available.

Number	Title
H0003	Agreement to Release Your Facts	ES
H0004	Consent for a Person Sponsoring an Immigrant	ES
H0005	Policy Clarification Request
H0011	Texas Simplified Application Project (TSAP) for SNAP Food Benefits	ES
H0011R	Texas Simplified Application Project (TSAP) for SNAP Food Benefits Renewal	ES
H0025	HHSC Application for Voter Registration	ES
H0050	Parent Profile Questionnaire
H0070	Food Stamps Streamlined Reporting (Income Calculation Worksheet)
H0901	HHSC Enhanced Data Gathering Worksheet
H0920	Notice from the Community Organization Helping You
H0926	Sharing Facts About Me and My Case with a Community Partner	ES
H1000-A	Notice of Application
H1003	Appointment of an Authorized Representative	ES
H1004	Cover Letter: Authorized Representative Not Verified	ES
H1008	Authorization for Cancellation or Issuance of Public Assistance Warrants
H1008-A	Warrant Inquiry/EBT Benefit Conversion and Affidavit for Non-receipt of Warrant
H1009	TANF/SNAP Benefits Notice of Eligibility
H1010	Texas Works Application for Assistance - Your Texas Benefits (English and Spanish)	ES
H1010-MR	MAGI Renewal Addendum	ES
H1010-R	Your Texas Works Benefits: Renewal Form
H1012	Immunization Record
H1013	Electronic Correspondence Confirmation Letter	ES
H1014-A	Children's Health Care Benefits - Final Reminder	ES
H1015	Electronic Correspondence Failed Delivery	ES
H1016	Supplemental Security Income Referral
H1017	Notice of Benefit Denial or Reduction
H1017-B	Transitional Medicaid
H1017-P	Notice of Benefit Denial/Personal Responsibility Agreement (PRA) Reasons	ES
H1018	Overpayment Claim
H1019	Report of Change	ES
H1019-F	Reporting Changes to Your Case	ES
H1020	Request for Information or Action	ES
H1020-A	Sources of Proof
H1021	Payment Agreement - Verbal Authorization for One-Time Debit of an Active Lone Star Food Account
H1024	Subject: Self-Declaration Notice
H1026	Verification of Railroad Retirement Benefits
H1026-FTI	Verification of Railroad Retirement Benefits - FTI
H1027-A	Medicaid Eligibility Verification
H1027-B	Medicaid Eligibility Verification - MQMB
H1027-C	Medicaid Eligibility Verification - QMB
H1027-F	Proof of Health Care Coverage
H1028	Employment Verification	ES
H1029	Notice of Case Action
H1030	Supplemental Nutrition Assistance Program (SNAP) Lone Star Card Assistance	ES
H1036	Refugee Cash Assistance Verification Form
H1038	Medical Facility Referral
H1039	Medical Insurance Input
H1040-A	Application Suspense File Card
H1040-B	Review Suspense File Card
H1040-C	Change Suspense File Card
H1041	Worker Activity Log
H1042	Modified Adjusted Gross Income (MAGI) Worksheet: Medicaid and CHIP
H1044	Standby Log
H1046	Inpatient Medical Services Certification	ES
H1049	Client's Statement of Self-Employment Income	ES
H1050	Check Verification
H1057	Declaration of Informal Marriage
H1059	Interview Observation Instrument
H1060	Case Preparation Guide
H1061	Birth Outcome Letter	ES
H1062	Birth Outcome Reminder Letter	ES
H1063	Request for Review Outcome Letter	ES
H1064	CHIP Continued Enrollment Letter	ES
H1065	Tuition and Fee Exemption Letter
H1071	Family Violence Exemption for Medicaid and CHIP	ES
H1072	One Time Temporary Assistance for Needy Families (OTTANF) Acknowledgement
H1073	Personal Responsibility Agreement	ES
H1074	SNAP Force Change Request
H1075	Welfare Reform Force Change Request
H1076-A	Notice of TANF State Time Limits
H1076-B	Notice of TANF State Time Limit Months Used/Changed/Corrected
H1076-C	Notice of End of TANF State Time Limit/Hardship Exemption
H1077	Notice of TANF Federal Time Limits
H1079	Qualifying Quarters of Social Security Earnings
H1082	TANF Grandparent Supplement Payment Request
H1084	Certification for Warrants Lost, Destroyed, Stolen or Not Received
H1086	School Attendance Verification
H1087	Verification of Texas Health Steps Checkup
H1088	Verification of Parenting Skills Training
H1093	Texas Health Steps Extra Effort Referral
H1094	Notice of TANF-SP Time Limit	ES
H1095	Treatment Facility Fraud Referral
H1096	Notification Letter
H1097	Affidavit for Citizenship/Identity	ES
H1100	Addendum Income Worksheet
H1101	TANF Worksheet
H1102	TANF Worksheet for Special Reviews and Denials
H1103	Verification of TANF Eligibility
H1104	90% Earned Income Deduction (EID) Eligibility and Tracking
H1105	SNAP Expedited Screening Sheet
H1106	Enumeration Referral	ES
H1106-A	Proofs You Need to Apply for a Social Security Number Card
H1107	Request for Forced Change of Medical Coverage
H1111	Card Order Discrepancy Verification
H1113	Application for Prior Medicaid Coverage
H1119	Medical Programs Income Worksheet
H1120	Medical Bills Transmittal/Insurance Information
H1122	Medicaid Action Notice
H1131	Individually Identifiable Health Information Fax Transmittal
H1133	Account Verification
H1134	Help Statement Verification
H1135	Child Care Expense Verification
H1136	Child Support Verification
H1137	Confirmation of Office Visit Work/School Excuse
H1138	Living Arrangement Verification
H1139	Medical Expense Verification
H1140	Verification of Benefits
H1146-M	Medicaid Report (Manual)
H1155	Request for Domicile Verification
H1163	TWC Employment Registration
H1172	EBT Card, PIN and Data Entry Request	ES
H1173	EBT Card Issuance Log
H1174	Inventory of EBT Cards
H1175	EBT Change Request
H1177	Transmittal and Receipt for Controlled EBT Documents
H1184	Here Is Your Lone Star Card	ES
H1185	Important Information About Your Lone Star Card
H1187	Welcome to Texas Health Steps Medicaid!
H1188	Common Questions Asked About Texas Health Steps and Your Child's Medicaid
H1190	Ending TANF Five Year Freeze Out Disqualification
H1205	Texas Streamlined Application	ES
H1213	Children's Health-Care Benefits: More Facts Needed from the Parent Who Has Custody	ES
H1240	Request for Information from Bureau of Veterans Affairs and Client's Authorization
H1265	Presumptive Eligibility (PE) Worksheet
H1266	Short-term Medicaid Notice: Approved	ES
H1267	Short-term Medicaid Notice: Not Approved	ES
H1350	Opportunity to Register to Vote
H1550	Out of State NBCCEDP Verification
H1551	Treatment Verification
H1701	Child Support, TANF Foster Care and TANF/Medicaid Case Information Exchange
H1706	Good Cause Recommendation and Family Violence Exemption
H1708-A	Report of Noncooperation (Automated)
H1710	Payment Identification/Identificacion Pagado
H1712	Explanation of Child/Medical Support, Family Violence and Good Cause	ES
H1713	Service Plan for Family Violence Option and Report of Good Cause	ES
H1800	Receipt for Application/Medicaid Report/Verification/Report of Change
H1801	SNAP Worksheet
H1802	Voluntary Withdrawal from Temporary Assistance for Needy Families (TANF)
H1805	SNAP Food Benefits: Your Rights and Program Rules	ES
H1806	Parole/Community Supervision Report	ES
H1808	SNAP Work Rules	ES
H1816	SNAP E&T Noncompliance Report
H1817	SNAP Information Transmittal
H1822	ABAWD E&T Work Requirement Verification
H1825	Entitlement to Restored Benefits	ES
H1826	Case Information Release	ES
H1830	Application/Review/Expiration/Appointment Notice
H1830-I	Interview Notice (Applications or Reviews)
H1830-R	Texas Works Renewal Notice
H1832	Affidavit for Meal Providers to the Homeless
H1833	Your Medicaid Benefits Are Ending - Cover Letter	ES
H1833-L	Your Medicaid Benefits Are Ending	ES
H1834	Your Medicaid Benefits Have Ended - Cover Letter	ES
H1834-L	Your Medicaid Benefits Have Ended	ES
H1836-A	Medical Release/Physician's Statement	ES
H1836-B	Medical Release/Physician's Statement	ES
H1837	Physician's Statement of Permanent Disability
H1841	SNAP-CAP Application	ES
H1842	SNAP-CAP Renewal Application	ES
H1843	FNS Authorized SNAP-CAP Benefit Increase Notice
H1845	Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facility Review
H1846	Facility Authorized Representative Interview
H1847	Reminder to Submit Form H1852
H1851	Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities
H1852	List of Resident Participants in the Supplemental Nutrition Assistance Program (SNAP)
H1853	Documentation of Findings for Form H1852
H1855	Affidavit for Nonreceipt or Destroyed Supplemental Nutrition Assistance Program (SNAP) Benefits
H1856	SNAP Out-of-State Intentional Program Violations
H1857	Landlord Verification
H1858	Items We Might Need from Anyone on Your Case	ES
H1859	Social Security Administration Benefits for People with Disabilities Receiving TANF
H1860	TANF Social Security Outreach Letter
H1861	Federal Tax Information Record Keeping and Destruction Log
H1862	Federal Tax Information Transmittal Memorandum
H1863	Federal Tax Information Removal Log
H1864	Federal Tax Information Fax Transmittal
H1866	Federal Tax Information Visitor Access Log
H1869	Renewal for Health Care Benefits	ES
H1870	School Enrollment Verification Form	ES
H1898	Restored Benefits Documentation
H1901	TIERS Data Collection Worksheet
H2067	Case Information
H2340-OS	Medicaid for Breast and Cervical Cancer	ES
H2580	TANF Employment Services Notice	ES
H2581	Choices Noncooperation Report
H2583	Choices Information Transmittal
H2588	Workforce Orientation Referral
H2776	Job Search Worksheet for TANF Employment Hardship Exemption	ES
H3037	Report of Pregnancy
H3038	Emergency Medical Services Certification	ES
H3038-P	CHIP Perinatal - Emergency Medical Services Certification	ES
H4100	Money Receipt
H4701	HHSC Out Card
H4800	Fair Hearing Request Summary
H4800-A	Fair Hearing Request Summary (Addendum)
H4803	Notice of Hearing
H4804	Request and Authorization for Fair Hearing Record to Remain Open
H4807	Action Taken on Hearing Decision
H4837	Fair Hearings Evidence Packet Cover Letter
H4857	Notice of Decision, Administrative Disqualification Hearing
H4870	Client Complaint of Discrimination (English-Spanish Version)
H5799	TANF Warrant/Envelope
HRG-83	SSN Maintenance Memorandum
SCR	Secondary Cardholder Request
SSA-2853	Message From Social Security
SSA-3288	Social Security Administration Consent for Release of Information