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Dshs.texas.gov/elp/ Texas Only: 8005725548 Local 5128346600 Fax: 5122063782INDIVIDUAL NAME CHANGE APPLICATION DO NOT WRITE IN THIS BOX FOR DSS USE ONLY BUDGET/FUND: ZZ112085 REMIT #RCD DATE: ___ UNIT:

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Contact Us - Texas is a form used by certain businesses and organizations in Texas to provide their contact information and ensure compliance with state regulations.

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