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.

    If still having trouble viewing or downloading a form, click here.

Effective Date: 




Updated: 5/2003



To provide staff a way to verify living arrangements when a client resides with another family or friend.



When to Prepare

Use this form to verify a living arrangement.

Number of Copies

Give or mail the client or person the client resides with one copy of the form with an addressed, stamped envelope.


Keep the completed form with the appropriate application or change report form.


See the Texas Works Manager's Guide.


Detailed Instructions

Enter the

  • name and address of the person providing the information;
  • date, advisor name, office address, and office telephone;
  • case name and number;
  • date the form is due; and
  • client's name in the space giving his permission for release of the requested information. The client signs and dates the form in the appropriate spaces. The advisor indicates which section(s) are to be completed.

The person the client lives with completes the remainder of the form.