Form 1578, Qualified Income Trust (QIT) Copayment Agreement

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 (94.7 KB)
Downloads: 5
Source
https://www.hhs.texas.gov/regulations/forms/1000-1999/form-1578-qualified-income-trust-qit-copayment-agreement

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