Pasadena, TX · Harris County
Verification of Disability
This form documents a Community Development Block Grant applicant’s disability status for eligibility purposes and is completed by the applicant and, when needed, a medical professional.
What this form is
The City of Pasadena Community Development Department uses this form to verify disability status for a named CDBG program applicant’s eligibility file. The form provides three verification methods: an obvious disability, receipt of federal disability benefits, or certification by a medical professional. It asks for applicant and program information, selected verification and supporting documentation, and signatures and dates.
Who needs it
A CDBG program applicant seeking assistance and, when medical certification is needed, the applicant and a medical professional complete the applicable sections.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed and dated without a notary; it includes a perjury certification, but no notarized attachment or related step is specified.
How to submit this form
- 1
Download The Form
Download the Verification of Disability PDF.
- 2
Complete Applicant Information
Enter the program name, applicant name, date, and address.
- 3
Select A Verification Method
Choose one of the three methods and provide the documentation required for that method.
- 4
Gather Any Supporting Documentation
For benefit verification, provide reasonable documentation such as a benefit letter, canceled checks, or direct deposit records.
- 5
Submit To The City
Submit the form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Verification of Disability?
- No. The form is signed and dated without a notary. It includes a perjury certification, but no notarized attachment or related step is specified.
- How do I submit the Verification of Disability?
- Submit it to the city department named on the form; check the city website for current contact details.
- What verification methods does the form list?
- It lists an obvious disability, receipt of federal disability benefits, or certification by a medical professional. Select one method and provide its required documentation.
- When is medical professional certification used?
- The form says to use medical professional certification when the applicant does not have an obvious disability and/or does not receive disability-related federal benefits.
Need something notarized?
This Verification of Disability doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.