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How to fill out the TX 5873 online
Completing the TX 5873 form is essential for organizations applying to be providers for Home and Community-based Services and Texas Home Living Waiver Programs. This guide will help you navigate the form's sections and provide a clear, step-by-step approach to filling it out online.
Follow the steps to effectively complete the TX 5873 online.
- Press the ‘Get Form’ button to access the TX 5873 application form and open it in your chosen editor.
- Begin by filling in the legal entity name and the Doing Business As (DBA) name if applicable. Ensure that the names are typed or clearly printed.
- Check the first box to confirm that you have typed or legibly printed the application packet. Remember, do not include the form instructions with your submission.
- Review the checklist items that are required for submission. You must check the boxes next to each item you are including in your packet, including Form 3681, DADS notification letter, and others listed.
- Depending on your entity type, provide the relevant documentation requested, such as Certificates of Formation, Social Security Cards, and Driver’s Licenses as appropriate.
- Make sure to include copies of any necessary certifications, such as the Employer Identification Number and National Provider Identifier confirmation, if applicable.
- Complete the signature section where the authorized person must sign. Ensure the signatory's name is the same as listed on the Form 2031 that is on file with DADS.
- Once all sections are completed, save changes to your application. You may also download, print, or share the TX 5873 form as needed.
Start filling out your TX 5873 form online now to efficiently complete your application process.
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