- To serve as an initial application for the Texas Simplified Application Project (TSAP) for SNAP food benefits.
- To serve as a screening document for TSAP applicants who may be entitled to expedited service.
- To serve as a document for households to designate an authorized representative (AR).
- To serve as a document for an AR's acknowledgement of an AR's responsibilities.
- To serve as a screening document for advisors to make necessary referrals to other agencies.
- To provide applicants and recipients the opportunity to register to vote.
When to Prepare
The household completes the form when applying for TSAP.
If an applicant needs help completing the application packet, a volunteer or staff member must help. Anyone that helps to complete the application must initial the part completed, or sign the form showing that the assisting person helped complete it.
Clients may fax the form to 877-447-2839 or mail it to:
Health and Human Services Commission
P.O. Box 149024
Austin, TX 78714-9968
The form is client-completed. To evaluate specific answers, refer to policies in the Texas Works Handbook.
Signing up to vote — Give Form H0025, Voter Registration Application, to clients who indicate an interest in registering to vote and who meet the voting registration requirements. ARs or representative payees also may take Form H0025 to the client to complete. Mail Form H0025 when the client does not have a face-to-face interview or the client reports a change of address by phone or by mail. If requested, assist in the completion of Form H0025.
If the applicant or client declines to register to vote during an in-person interview, ask the client to sign Form H1350, Opportunity to Register to Vote. Mail Form H1350 to a client who did not have a face-to-face interview who declines the opportunity to register to vote, based on receipt of Form H0025.
Voter Registration Status — Check the appropriate box under Agency Use Only and sign.