Blank Texas Veterans Commission PDF Form

The Texas Veterans Commission form, known as the TVC15b Assisted Living Statement, plays a vital role in assisting veterans and their families in navigating the complexities of assisted living care. This form requires essential information, including the name of the veteran or their widow, as well as details about the assisted living facility, such as its address, telephone number, and license number. When completing the form, it’s important to include the veteran's name, claim number, or Social Security number, alongside the claimant's mailing address. The statement also outlines the charges associated with assisted living, detailing the amount of recurring gross daily charges and any expenses that have not been reimbursed. A certification section is included, where the claimant affirms that the costs are being paid from personal funds without any reimbursement. This helps ensure that the expenses can be considered for a continuing deduction from the claimant’s countable income. The form also addresses whether the claimant requires assistance and notes any disabilities that necessitate care. Lastly, additional remarks can be made, including eligibility for Medicare, and the form must be signed by both the claimant and an administrator from the assisted living facility, ensuring that all necessary information is documented accurately.