Downloading a Form to Your Computer
Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.
- Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
- Select the folder you want to save the file in and then click "Save."
- Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.
Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.
To authorize the Texas Health and Human Services Commission (HHSC) to use electronic data sources to verify income and resource information from an individual sponsoring an immigrant who has submitted an application for benefits.
When to Prepare
If the sponsor agrees and verbal authorization is insufficient, HHSC staff complete Form H0004 to obtain authorization.
Number of Copies
Staff obtain the sponsor’s signature on the original form during the application process or at the time of the redetermination.
Staff send the form to the person providing information.
There is no retention requirement.
Staff complete the identifying information at the top of the form. The sponsor and spouse (if applicable) must sign the form.