To request information from banking institutions or credit unions regarding a client's checking and/or savings account, as well as any certificates of deposit, individual retirement accounts, etc., that the client may own.
Use this form to verify account information.
Give or mail the client or financial institution one copy of the form with an addressed, stamped envelope.
File the completed form on the right side of the case folder with the appropriate application or change form.
See the Texas Works Manager's Guide.
Staff enters the
The financial institution completes the remainder of the form. All items are self-explanatory.
Note: Do not enter Tax-Sensitive Information on the form before sending it to banking institutions or credit unions. See procedures in C-1000.