Form H1832
Instructions

Affidavit for Meal Providers to the Homeless

5-2001

PURPOSE

PROCEDURE

When to Prepare

Complete Form H1832 when a Meal Provider contacts HHSC for approval as a meal provider to the homeless. (Make necessary copies from the handbook sample; this form is not stocked.)

Number of Copies

Prepare an original and one copy.

Transmittal

File the copy and give the original to the meal provider.

Form Retention

Keep copies of Form H1832 indefinitely.

DETAILED INSTRUCTIONS

The meal provider must complete and sign Form H1832 at the interview.

Staff must complete, sign, and date the bottom portion of Form H1832.