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H61.1 HSA27
Reviewed: 07/18TEXAS DEPARTMENT OF CRIMINAL JUSTICEHEALTH SERVICES DIVISION
AUTHORIZATION FOR THE USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION (PHI)
Patient Name (print): PATIENT×NAMEOffender
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What is h-61?
H-61 is a form used for reporting certain tax information.
Who is required to file h-61?
Individuals or entities who meet specific criteria as outlined by the tax authority.
How to fill out h-61?
H-61 can be filled out manually or electronically, following the instructions provided by the tax authority.
What is the purpose of h-61?
The purpose of h-61 is to report specific tax information to the tax authority.
What information must be reported on h-61?
Information such as income, deductions, credits, and other relevant tax details.
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