What documents do I need to bring?

ProofThat You Live in Collin County, Texas

Provide twoacceptable documents from the list below that contain your name and the address where you physically residein Collin County, TX. (P.O. boxes will not be accepted) Both documents cannot be from the same source.

  • Current utility bill in applicant’s name. (An electric, water, gas, television, or non-cellular telephone statement dated within the last 30 days.)
  • Current voter registration from the applicant
  • Texas ID or Texas Driver’s License with Collin County, Texas address
  • Current Lease agreement in applicant’s name
  • Current Automobile Insurance Policy or statement
  • Current homeowner’s or renter’s insurance policy or statement
  • A letter from a representative of a governmental entity, not-for-profit organization, assisted care facility/home, adult assisted living facility/home, homeless shelter, transitional service provider, a group/half way house certifying to the address where the applicant resides or receives services and verifying they receive mail for the applicant in lieu of two acceptable residency documents.
  • Letter from shelter stating you have zero income AND that they are supplying food and shelter. (Letter must include their phone number and be signed and dated by the shelter).

Please Note: You cannot qualify for assistance for more than one county at the same time.

Proof of Your Household’s Income (or Letter of Assistance)

Provide proof of monthly gross household income (any type of payment that is of gain or benefit to the household) for you and your spouse, from all sources before taxes and other payroll deductions.

(Child support received is not considered income.)

►For individuals under 18, proof of parent’s income is required. (Step-parents are not financially responsible for

their spouse’s children.)

Income Types:(Provide all sources of income that apply)

  • Client Wages – wages paid to the client by an employer, including self-employment (pay check stubs from the last 30 days or letter from employer stating pay rate, hours worked, employer’s signature and phone number, and date)
  • Spouse Wages – Wages paid to the client’s spouse
  • Parent Wages (For Children and Adolescents) – Wages paid to the client’s parent if the client is less than 18 years old
  • Retirement/Pension Income – Income from retirement or pension funds
  • Social Security/SSI/SSDI – Income from Social Security, SSI, and/or SSD
  • Veteran’s – Income received through veteran’s benefits
  • Unemployment Income - Bookkeeping, Sales, Expenditure Records, Statement
  • TANF – Income received through the Temporary Assistance for Needy Families (TANF) program
  • Workman’s Compensation – Income received through a Workman’s Compensation program
  • Trust Distributions – Income received from a trust distribution
  • Interest Income – Income received from interest on investments
  • Civil Service or Railroad Income – Income received through Civil Service or Railroad retirement programs
  • Verification of Assistance Letter (If someone is assisting you financially and/or covering your expenses)
  • Other - Income received from other sources

Proof of Extraordinary Expenses (if any)

Provide receipts showing the amount and type of extraordinary expensespaid during the past12 months. (May project extraordinary expenses for the next 12 months butyou must continually prove paymentby presentation of receipts every month.)

►Types and Definitions for Extraordinary Expenses are:

  • Major Medical – This is the amount of extraordinary expenses due to catastrophic medical expenses for serious illness or hospitalization.
  • Major Casualty – This is the amount of extraordinary expenses due to major casualty losses. A Major Casualty Loss is a household disaster that results from a fire, flood, tornado, accident, or other similar events that affected only that household, or any number of households. (Damage or destruction resulting from household neglect, such as damage caused by pets, or children may be a disaster but it is not considered a “disaster” for the purpose of calculating Extraordinary Expenses.)
  • Child Care – This is the amount of extraordinary expenses to provide child care for a child in the household.

Proof of Number of Family Members in Your Household

Provide documentation for all applicable family members (as defined below) that are living with you in the household.

Examples include: Social Security Cards or Birth Certificates

►Family members are defined as the following:

1)For an unmarried person age 18 years or older – The person and his/her dependents;

2)For a married person of any age – The person, his/her spouse, and their dependents.

3)For an unmarried person under the age of 18 years – The person, the person’s parents, and the dependents of the parents, if residing in the same household.

*Family members who live outside the home are not counted.

Proof of Third-Party Insurance Coverage (if any)

Provideall insurance cards

Examples include:

  • Medicaid, Medicare, CHIP, Tricare, Marketplace/Affordable Care, or private commercial insurance card

Photo ID for All Adults in Your Household

Provide a photo ID issued by a government agency, school, or work.

Examples include:

  • Texas Driver’s License
  • Texas ID
  • School ID card
  • Inmate/Probation/Parole ID card
  • Passport
  • Library card

Proof of Social Security Number

Examples include:

  • Social Security card (actual card)
  • W-2 or 1099 Tax Form with SSN
  • Birth certificate with SSN
  • Dependent Military ID with SSN
  • Pay Stub with SSN

Proof of U.S. Citizenship for You and Your Household Members(Optional)

Examples include:

  • U.S. Birth Certificate
  • Legal Permanent Resident Card
  • Certificate of Citizenship
  • U.S. Passport
  • U.S. Citizenship Identification Card

Proof of Any Other Health Care Benefits for Which You Have Been Approved, Been Denied, or Have a Pending Application

Examples include:

  • Denial letter from Medicaid or CHIP
  • Letter from Social Security Administration (SSA) indicating a pending application
  • Letter indicating a pending application for TANF / Medicaid
  • Medicaid enrollment verification letter
  • Medicare card
  • Private insurance card

Proof that You are the Parent or Legal Guardian of all Applicable Children, Adolescents, or Incapacitated Adults in your Household

Provide all of the following that apply:

  • Parent or Guardian’s Driver’s License or State Issued Photo ID (required)
  • Child’s Birth Certificate and Child’s Social Security Card (required)
  • Adoption Papers (if applicable)
  • Legal Guardianship Papers (if applicable)
  • Custody Documents (if applicable)
  • Divorce Decree - (required if child’s parents are divorced)

Please Note: The child, adolescent or incapacitated adult must be present for the assessment.