Form H1177, Transmittal and Receipt for Controlled EBT Documents

Texas Health and Human Services

This government document is issued by Texas Health and Human Services for use in Texas

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File Details: PDF (111 KB)
Downloads: 4
Source
https://www.hhs.texas.gov/regulations/forms/1000-1999/form-h1177-transmittal-receipt-controlled-ebt-documents

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