Form 1023 Texas 2020-2024

Form 1023 Texas: What You Should Know

A request for a waiver shall be filed with the Department in accordance with this form by the applicant or his or her authorized representative at or before the time when the individual is expected to leave the program for which a waiver is requested. However, an application may be filed as a supplement to an existing waiver application. There are two provisions in this form to which an applicant or his/her designated representative must respond: (6) What changes to current program operations will you make? (7) Explain how your participation in the program changes or affects your ability to obtain current financial assistance from another source? (8) What is your current income, and how is it calculated? Provide one of the following three responses to (8): (a) “The current annual income on which financial assistance is based is below 50% of the poverty level.” This may not be included in an income statement for a waiver participant (9) “This means my income for the current fiscal year was less than 250% of the federal poverty level applicable if the current financial assistance is considered a hardship by the Department.” This need not be included in an income statement for a waiver participant. This information must be included in the waiver applicant's current income statement (10) Other. Specify one of the following: (a) Name of the individual participating in the program, such as family, friends, employer, etc. (b) Date of birth of the individual, by date of birth (i.e., the latest available year) (c) Reason for the application, such as that you have a disability or qualify for subsidized housing. (12) A completed, signed, and notarized application must be notarized. This is not a “do-it-yourself” paper application. It must be accompanied by a 35.00 application fee, including both fingerprinting and a Texas driver license photo. There is a 100.00 application processing fee. If you are not an officer, director, or employee of the Department of Housing & Community Affairs at the time you file this form, you must pay this fee. A separate application will be required to request approval of your application. Application for the waiver must be received by the Department's Regional Counsel (RCC) no later than January 31 of each year.

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