Number Name Purpose
1513 Disclosure of Ownership and Control Interest Statement Documents ownership and financial interest information.
2030 Budget for Purchase of Services Contracts Budget for Cost Reimbursement contracts
2030 CLIVE Budget for Title IV-E County Contract Budget for Title IV-E Legal services contracts
2030 CWIVE Budget for Title IV-E County Contract Budget for Title IV-E Child Welfare services contracts
2031PEI Signature Authority Designation Signature authority designation
  HHSC Uniform Terms and Conditions (for Vendors, or State or Local Governmental Bodies)  
2970C Disclosure and Consent to Release of Information Regarding Criminal or Abuse/Neglect History For Applicants, Employees or Volunteers of DFPS Contractors and Subcontractors Release of information regarding criminal history or DFPS abuse and neglect history.
2971C Request for Criminal History and DFPS History Check Application for requesting criminal history and DFPS abuse or neglect history.
4110x Texas Identification Number Change Request Change the identification number
4734 Federal Funding Accountability and Transparency Act (FFATA) Certifications The form is required for any DFPS subrecipient contracts and any other sub-awards granted under a federal cooperative agreement or grant.
4735 Out of State Contractor Certifications Certifies compliance with business entities laws of the state where the contractor does business and that the contractor is not delinquent in state or federal taxes.
4736 DFPS Certificate of Insurance The Certificate of Insurance is the only proof of insurance accepted by DFPS, unless the contractor is self-insured. This Certificate of Insurance has been approved by the Texas Department of Insurance.
5622 DFPS Special Attachment to HHSC UTC Required attachment to HHSC Contract Templates for all DFPS contracts.
5622SR DFPS Special Attachment for Subrecipients to HHSC UTC Required attachment, to HHSC Contract Templates for DFPS Subrecipient contracts in addition to the 5622
5622FCR DFPS Special Attachment for Foster Care Redesign to HHSC UTC Required attachment, to HHSC Contract Templates for DFPS Foster Care Redesign contracts in addition to the 5622
74-176 Vendor Direct Deposit Authorization For vendor to receive direct deposit
9007CR Internal Control Structure Questionnaire and Instructions (ICSQ) for Cost Reimbursement Contracts Contractor's disclosure of internal controls to safeguard assets. Instructions included.
9007ICC Internal Control Certification (ICC) For contractors to certify there have been no internal control changes
9007CIVE_S Internal Control Structure Questionnaire (ICSQ) for Title IV-E County Between $10,000 and $24,999 Contractor's disclosure of internal controls. Instructions included.
9007CIVE Internal Control Structure Questionnaire (ICSQ) for Title IV-E County > $25,000 Contractor's disclosure of internal controls. Instructions included.
9007CPG Internal Control Structure Questionnaire (ICSQ) for Community and Parent Groups Contractor's disclosure of internal controls. Instructions included.
9007FFS Internal Control Structure Questionnaire (ICSQ) for Fee for Service Contracts Contractor's disclosure of internal controls. Instructions included.
9007Claims Internal Control Structure Questionnaire (ICSQ) for Claims Processing Contractor's disclosure of internal controls. Instructions included.
9007RCC Internal Control Structure Questionnaire (RCC) Contractor's disclosure of internal controls. Instructions included.
9025a Related Party Leases/Rental Worksheet Form used by Residential Child-Care Contracts to determine and manage Contractor Related party leases/rental agreement(s)
9105 Risk Analysis Questionnaire (RAQ) Questionnaire for provider to assist staff with the completion of the Risk Assessment Instrument (RAI).
AP-152 Application for Texas Identification Number/Additional Mailing Address Application for identification number