Your Eligibility Specialist may request some of the following:

INCOME

• STATEMENT OF SUPPORT FORM completed and signed by everyone who helps to support you and a copy of the supporter(s) driver’s license/ID
• A copy of the Texas Workforce Commission Registration Form with a current date stamp
• Income Tax Return
• Current proof of any fixed income, such as: widow’s benefits, retirement, pension, dividend payments, unemployment, current verification for Workmen’s compensation medical benefits OR denial of benefits, etc.
• Current award/denial letters for TANF, Housing and Food Stamps or any other assistance program (bring all pages of those that apply)
• If employed:
  • Four (4) most recent paycheck stubs and complete the EMPLOYER VERIFICATION FORM
  • If paid in cash, you must bring a statement from your employer verifying your income
  • If self-employed, please complete the SELF-EMPLOYMENT FORM for the last 3 months and current month, also provide all expense receipts for each of the months.
  • If you have unpaid medical bills from the past 3 months, then we need all paycheck stubs for those months as well
• If receiving Social Security:
  • Current Social Security Award Letter for both spouses and any children receiving it
• If receiving Child Support:
  • Current Child Support Statements (Print out from Attorney General or court-ordered child support).
• If divorced:
  • Copy of Divorce decree or AFFIDAVIT OF SEPARATION  and DOMICILE VERIFICATION FORM

RESIDENCY

• Property tax or rent receipt

RESOURCES

• Complete bank statements from checking, savings, and business accounts (for last 3 months OR more and present)
• Verification of stocks, bonds, or retirement accounts
• Automobile registration or title for all vehicles in the household regardless of whose name the vehicle is in (If you still owe money for the vehicle please submit the most current statement that shows the current balance)

MEDICAL NEED

• If an applicant is unable to work, applicant must provide a letter or documentation from their physician stating inability and duration of inability to work

VERIFICATION OF OTHER ASSISTANCE

• Medicaid/Medicare (for self or household members)

WHAT HAPPENS NEXT?

• Your application and documentation will be pre-screened by a caseworker.
• If there is any documentation needed to make a complete application, you will be notified by mail and asked to submit the additional information.
• Once your application is complete, we will complete the pre-screen process and notify you by phone or mail to set up an appointment.      (We reserve the right to request additional information at  any time during the application or interview process.)

• Should your case be denied, you will be mailed a denial letter.

For further information, please contact the HCAP office at (936) 523-5101 or send an email to HCAPeligibility@mchd-tx.org.