Case Number: 1068928677

09/12/2025

Need Help? Call 2-1-1

or for out of the state callers,
call 1-877-541-7905
David A Morales I Fax: 1-877-447-2839
Apt 103A
2885 Mabe RD Mail: Texas Health and Human Services
San Antonio TX 78251-1500 Commission
PO Box 149024
Austin Texas 78714-9024
If you have a hearing or speech disability,
call 7-1-1 or any relay service.

To find out if you can get or keep getting benefits, we need more facts from you:
You are getting this packet because either: (1) you applied for benefits, (2) you reported a change to your case, or (3)
we must check your income to see if you can still get benefits.
Inside this packet you will find:
• A list of the items we need from you.
• A pre-paid envelope.

You also might find other forms you can fill out and send to us.

Send us the items by 09/22/2025

If you need help, call us at 2-1-1 or 877-541-7905. After you pick a language, press 2. We can take your call
Monday to Friday, 8 a.m. to 6 p.m. Central Time.
For help or questions about your Lone Star Card account, call 1-800-777-7328 (7EBT).
You still need to send us the items by this due date.

If you don't send us your items by this date,

you might not get benefits or your benefits might end.

There are 4 ways to send us the items we need:

Pick one of these ways to send the items back to us:
• [Link]: You can upload your items online.

• Your Texas Benefits Mobile App: You can upload your items using the mobile app.
The app is free to download in the Google Play and Apple iTunes stores.

• Mail: Mail this letter and the items we need in the pre-paid envelope that came in this packet.

•
Fax: Fax this letter and the items we need to 1-877-447-2839.

Don't forget:
• Put your case number on everything you send us.
• If you send us a letter or statement showing proof of facts we need, make sure the person who writes it includes:
(1) their name, (2) their address, (3) their phone number, (4) the date they wrote it, and (5) their signature.

Form 1020 Page 1 of 4

12/2022 T-01020-0903299716
 Benefit programs affected and due date:

Program EDG number Due date

For Food Stamp benefits: 752397137 9/22/25

If you're afraid that giving us facts about someone could cause harm (physical or emotional) to you or
your child:
If you're applying for or renewing Medicaid or CHIP benefits, you might not need to give us facts about that
person. You might be able to get the "Family Violence Exemption."
Let us know if you're afraid to give facts about someone:

• Phone: Call 2-1-1 or 1-877-541-7905 (after picking a language, press 2).

• Mail: TEXAS HEALTH AND HUMAN SERVICES COMMISSION,P O Box 149024,

Austin, Texas 78714-9024
• In person: At a benefits office. To find one near you, go to [Link] or call 2-1-1 or
1-877-541-7905 (after picking a language, press 1).
• Fax: 1-877-447-2839.

Form 1020 Page 2 of 4

12/2022 T-01020-0903299716
 LIST OF INFORMATION NEEDED AND/OR ACTION REQUIRED:
Name(s) Program(s) Information/Action Requested Acceptable Verification/Proof
David Morales Food Stamps Provide verification of where you live. Bill/receipt/records
Child care provider
Church or baptismal record
City or crisscross directory
DPS ID
Employer
Form 1857 Landlord Verification
Home visit
Mail received with name and address
Mortgage Company Statement
Non-relative
Official records of ownership of property
Post office records
Rent/mortgage receipt
School or Day Care Record
Telephone directory
Texas Motor Vehicle Commission (DMV)
Texas driver's license (valid)
VolAg
Voter registration card
David Morales Food Stamps Read, sign, and date the form we sent with this Form H1808-SNAP Work Rules
letter-

Form 1020-A Page 3 of 4

12/2022 T-01020-0903299716
 Texas Health and Human Services Commission
PO Box 149024
Austin Texas 78714-9024

Case Number:1068928677

The enclosed Missing Information form (Form 1020) includes a list of documents you need to send to us
so we can determine your eligibility for services.

See page 1 to find out how to send us your forms.

El formulario adjunto de información faltante (Formulario 1020) incluye una lista de documentos que
usted necesita enviarnos para que podamos determiner si usted reúne los requisitos para los servicios.

Vea la página 1 para saber cómo enviarnos sus documentos.

Form 1020B Page 4 of 4

12/2022 T-01020-0903299716
 Agreement to Follow SNAP Work Rules
Name SNAP EDG number Date
David Morales 752397137 09/12/2025

Work rules:
You must follow these work rules to get SNAP benefits.

• Reply to all letters from jobs or work programs.

• Work at the job or train in the program you are in.
• Accept a job if you are offered one.
• Don't quit a job or work program without a good reason. If you're not sure if you have a good reason, call the Texas
Health and Human Services Commission (HHSC) to check. Call toll-free 2-1-1 or 877-541-7905 (after you pick a
language, press 2).

If you don't follow the work rules:

The penalties are:

• First time, no SNAP benefits for one month and until the person follows the rules.
• Second time, no SNAP benefits for three months and until the person follows the rules.
• Third time, no SNAP benefits for six months and until the person follows the rules.
Penalties usually end when the work rules are followed again.

Your rights and responsibilities:

• You don't have to take a job if: (1) it pays less than minimum wage, or (2) the work program staff finds a reason why that
job isn't right for you.
• You can appeal a decision made about your case.
• If you move, tell the job or work program and HHSC your new address.
• Tell HHSC if the amount of money you get from a job or work program changes.
• Tell HHSC if you get a new job or start a new work program.
• Let HHSC know if you can't meet a work rule.

HHSC found that a person in your household did not follow the SNAP work
rules. By signing this form, the person agrees to follow the SNAP work rules.

Sign here Date

Form H1808 T-H1808-0903299716

April 2023-E
This page intentionally left blank
 LANDLORD VERIFICATION
(This form must be completed by the client's landlord or a representative.)

Client Name: Case Number:

David A Morales I 1068928677

Please provide the tenant's complete residential address:

Street Address: Apt. No.: City: Zip:
2885 Mabe RD APT 103A San Antonio 78251

1. Date tenant moved in:

2. How many people live in the house or apartment?

3. List the names of all people who live in the house or apartment. List their employer, if known:

Name of Person Working? Employer

Yes No

4. Questions about the rent payment:

Amount of Rent: Tenant's Portion of Rent: Person making payment:

$ $
How often paid?

Weekly Every Two Weeks Twice a Month Monthly

Method of payment?

Cash Check Money Order Other (explain):

Is the tenant current in paying the rent? Yes No What is the total amount of past due rent?

If "No," when was the last month rent was paid? $

Form H1857 T-01857-0903299716 Page 1

09/2022
 5. Questions about the utilities:

Are all utilities included in rent? Yes No

Utilities the Tenant is responsible for paying (check all that apply): Gas Electric Telephone

Utility bills are paid directly to: Landlord Utility Company

Landlord or Representative Name (printed):

Signature - Landlord or Representative Date

Business Address or Residential Address: Telephone:

Form H1857
T-01857-0903299716 Page 2
09/2022