Hidalgo County, TX · Hidalgo County
WIC Assistance Documentation Form
This form documents income support or the absence of income for a WIC applicant and is completed by the applicant’s supporter or an eligible verifier.
At a glance
- Issued by
- City of Hidalgo County · Hidalgo County, Hidalgo County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- hidalgocounty.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form supplements a WIC application for income eligibility. It should be completed when an applicant reports that no one in the household has income; Section I may also document assistance from someone outside the household. It asks for the applicant’s and supporter’s names, assistance details, and signatures, or for an eligible person to certify that the household has no income or outside assistance.
Who needs it
A WIC applicant reporting no household income needs this form completed by a supporter or, for Section II, an eligible person who meets the stated requirements.
How to submit it
Submit it to the county office named on the form; check the county website for current contact details.
About notarization
This document is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download the Form
Download the WIC Assistance Documentation Form.
- 2
Complete the Applicable Section
Fill in Section I for support provided, or Section II to certify that the applicant’s household has no income or outside assistance.
- 3
Gather Any Attachments
The form does not identify any attachments to gather.
- 4
Submit to the County
Submit the completed form to the county office named on it; check the county website for current contact details.
Frequently asked questions
- Who completes the WIC Assistance Documentation Form?
- A person providing support may complete Section I. Section II may be completed by an eligible person, such as specified agency staff or a public official, who meets the form’s requirements.
- When should this form be completed?
- The form says to complete it if the applicant indicates that no one in the household has income. Section I may also document assistance from someone outside the household.
- Do I need a notary for the WIC Assistance Documentation Form?
- No. The form calls for signatures and dates, not notarization, and it does not identify any attachment or related step that must be notarized or sworn.
- How do I submit the WIC Assistance Documentation Form?
- Submit it to the county office named on the form. Check the county website for current contact details.