Texans can dial 2-1-1 (option 6) for information on COVID-19 and local community resources on health care, utilities, food, housing and more. More COVID-19 information.
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.
If still having trouble viewing or downloading a form, click here.
- To provide advisors with a standardized summary to inform applicants and recipients of their responsibilities as participants in the TANF (TP 01, 61) program.
- To emphasize with recipients the message of individual responsibility and self-sufficiency.
When to Prepare
Form H1073 must be signed by:
- caretakers (SIG 8) and second parents (SIG 7) who receive TANF [including teen parents that are caretakers] at initial interviews or at subsequent interviews if a signed form is not already on file or there has been a break in certification,
- payees and disqualified parents if a signed form is not already or file or there has been a break certification, and
- the advisors.
- If the second parent is in the home, he must sign a separate form.
- If the caretaker, second parent, payee or disqualified adult refuses to sign Form H1073, deny the case.
Number of Copies
File the original Form H1073 under "Legal" in the case record and give a copy to the client.
What are Your Responsibilities?
Refer to Texas Works Handbook Section A-2100. Explain each responsibility and the related penalties to each client and HHSC's responsibilities to provide support service.
Information on Additional Penalties
Continue to provide clients with Form H1712, Explanation of Child/Medical Support, Family Violence and Good Cause, and Form H2580, TANF Employment Services Notice.