Texas Form H1073: Personal Responsibility Agreement Rules and Appeals

Texas Form H1073, the Personal Responsibility Agreement, is the document every adult in a Temporary Assistance for Needy Families (TANF) household has to sign before the Texas Health and Human Services Commission (HHSC) will certify cash benefits. By signing, you commit to eight obligations covering work, child support, your children’s schooling and health, and your own conduct. HHSC staff walk you through each responsibility and the penalties for missing them during your application interview.¹

Who Has to Sign

Every caretaker, second parent, payee, and disqualified adult on a TANF case signs Form H1073, including minor parents who are applying as adults. You sign once, at the interview stage of your application. If you’re not present for the interview, your caseworker keeps the case open until they have your signature.¹

You don’t sign again as long as your case stays open. You do sign a new form if your benefits are denied and you later reapply, or if you’re added to an existing TANF case for the first time. At every periodic review, though, your caseworker goes back through the responsibilities and the penalties so you know where you stand.

The Eight Responsibilities You Are Agreeing To

The Personal Responsibility Agreement lists eight obligations. Signing binds you to all of them for as long as you receive TANF:²

Participate in the Choices program, the Texas Workforce Commission’s work and training program for TANF recipients, unless you qualify for an exemption.
Cooperate with child support requirements through the Office of the Attorney General.
Do not voluntarily quit a job without good cause.
Have your children screened through Texas Health Steps, the preventive medical and dental checkup program for children on Medicaid.
Have your children immunized, unless they have an approved exemption.
Have your children attend school regularly.
Attend parent-skills training if your caseworker refers you.
Do not abuse drugs or alcohol.

HHSC’s side of the agreement is to provide the cash assistance itself along with access to support services and referrals. The form is a condition of eligibility, not a formality.

What “Regular School Attendance” Means

Your caseworker checks school attendance at every complete review, and at the initial application if school is in session. Ten or fewer absences per semester, whether excused or unexcused, is fine on its face. More than ten triggers a formal verification request to the school on Form H1086, and the school itself decides whether the child is meeting attendance requirements. Absences for vacation, temporary illness, family emergencies, and disability-related instruction at home don’t count against the child. In summer, a child meets the requirement by being promoted to the next grade, attending summer school, or graduating.³

What Happens If You Don’t Comply

HHSC can enter a “PRA noncooperation” finding if you fail to meet the child support, voluntary-quit, or school attendance requirements after signing the form, even before your case is fully certified.¹

The child support piece carries the harshest penalty. If the state decides you aren’t cooperating with the Office of the Attorney General, HHSC terminates cash assistance for the entire family, not just your portion. You have 13 days from the non-cooperation notice to request a hearing and show good cause. Good cause is defined separately in the Texas Administrative Code and may include circumstances like domestic violence. Once the Office of the Attorney General confirms you are cooperating again, HHSC lifts the sanction.⁴

A Choices work sanction or child support sanction can also cost you the Medicaid coverage tied to your TANF participation. You don’t have to re-sign Form H1073 to get benefits reinstated after a Choices or child support sanction, as long as you come back into compliance before the end of the second month of non-cooperation.¹

One narrow protection exists for households taking in a child from another TANF case. If that child already has an open non-cooperation finding for immunizations, Texas Health Steps, or school attendance, HHSC will not hit the new household with a full-family sanction because of it.¹

How to Get the Form and Submit It

Form H1073 is available as a downloadable PDF from the HHSC website, in English and Spanish, and at any local HHSC benefits office. The form was last updated in January 2026.⁵

Once you’ve filled it out and signed it, you can submit it four ways:⁵

Online, by uploading through YourTexasBenefits.com.
In person at a local HHSC office.
By fax to 877-477-2839.
By mail to Texas Health and Human Services Commission, P.O. Box 149025, Austin, TX 78714-9025.

Keep a copy. If a dispute later comes up about whether you signed or when you submitted, that copy is your proof.

Appealing a Reduction or Termination

If HHSC reduces or ends your TANF because of a PRA violation, you can request a fair hearing in writing, by calling 2-1-1, or by visiting a local HHSC office. The deadline is 90 days from the date of the case action or the effective date on your Notice of Case Action. Late requests are reviewed for good cause before a hearing is scheduled.⁶

Hearings happen by conference call. HHSC mails you a notice with the date, time, toll-free number, and access code. At the hearing, the HHSC representative goes first with their evidence, and then you get to ask questions, testify, and present your own documents. The hearings officer may ask further questions before closing the record. If you don’t call in at the scheduled time, the officer dismisses your case for failure to appear.⁶

1
Texas Health and Human Services. Texas Works Handbook – A-2130, Form H1073, Personal Responsibility Agreement
2
Texas Workforce Commission. Choices Guide
3
Texas Health and Human Services. Texas Works Handbook – Determining Attendance
4
Legal Information Institute. 1 Texas Administrative Code 55.4 – Determination of Cooperation
5
Texas Health and Human Services. Form H1073, Personal Responsibility Agreement
6
Texas Health and Human Services. Fair and Fraud Hearings