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Form H1021 Payment Agreement - Verbal Authorization for One-Time Debit of an Active Lone Star Food Account - Texas
What Is Form H1021?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form H1021?
A: Form H1021 is a Payment Agreement - Verbal Authorization for One-Time Debit of an Active Lone Star Food Account in Texas.
Q: What is the purpose of form H1021?
A: The purpose of form H1021 is to obtain verbal authorization for a one-time debit from an active Lone Star Food Account in Texas.
Q: Who needs to fill out form H1021?
A: Individuals who have an active Lone Star Food Account in Texas and want to provide verbal authorization for a one-time debit need to fill out form H1021.
Q: What does form H1021 authorize?
A: Form H1021 authorizes a one-time debit from an active Lone Star Food Account in Texas.
Q: Is form H1021 specific to Texas?
A: Yes, form H1021 is specific to Texas and is related to Lone Star Food Accounts.
Q: Is form H1021 a payment agreement?
A: Yes, form H1021 is a payment agreement that involves a verbal authorization for a one-time debit.
Form Details:
- Released on January 1, 2002;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form H1021 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
