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.

  1. Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
  2. Select the folder you want to save the file in and then click "Save."
  3. 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.

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Effective Date: 



Updated: 7/1991


To serve as a reporting document for couples who request a resource assessment.


When to Prepare

Complete Form H1272 when the couple or responsible party requests an assessment.

Number of Copies

Complete only an original.


Send the original to the couple or responsible party.

Form Retention

Keep in case record for three years after case is denied.


The worker completes the top portion of the form. The client completes the rest of the form.