For JAWS users to read and complete the form, save the form as a Word document.

HHSC Forms and Instructions

Form H0062-MBIC

Form Record:

Number: H0062-MBIC
Title: Late Payment Notice
Effective Date: 01/2011
Instructions 01/2011

Availability

Word : H0062-MBIC.doc
Pdf : H0062-MBIC.pdf