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."
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Effective Date: 


Updated: 5/2018


State Law requires the Texas Health and Human Services Commission (HHSC) to collect fees for issuing licenses, registrations, and listings and for conducting background checks.  HHSC deposits the checks it receives in the state's general revenue fund.

When to Prepare

Complete the fee schedule form to submit with your fee payment. No cash is accepted.

Title 40 of the Texas Administrative Code, §§745.505-509 establishes the following fee schedule for listed family homes and applicants for a listing:

$20 application fee due before HHSC accepts the application.

$20 annual fee due on the anniversary date of the issuance of the listing.

$2 fee per person paid each time a Criminal History and Central Registry background check is requested.  


Mail the completed corresponding fee schedule form for your home and your check or money order to:

Texas Health and Human Services Commission
Accounts Receivable
P.O. Box 149055
Austin, TX 78714-9055


Certified or state-run operations are exempt from application and licensing fees. Licensed foster homes, licensed foster group homes and non-profit 24-hour operations that charge no fees for their services or that provide care for children in the managing conservatorship of the Department are exempt from paying provisional, annual and background check fees.