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An official website of the Texas state government

If you or someone you know is in need of assistance, please visit our Help for Texans Page.

Amy Young Barrier Removal Program Forms

Program Administration

Program Manual (PDF)

Reservation System User Guide (PDF)

Audit Certification Form

Audit Requirements Checklist

Contract and Reservation System Access Request Form

Program flyer (PDF) | Spanish version (PDF)

Program poster (PDF) | Spanish version (PDF)

EPA Lead-Based Paint RRP Program (

Program Forms

Activity File Checklist (XLS)

Stage 1 - Intake Application (DOC)

Stage 1 - Certification of Disability (DOC)

Stage 1 - Income Certification effective October 1, 2023 (XLSX)

Stage 1 - Applicant Identification Document Form (PDF)

Stage 2 - Initial Inspection Checklist updated 11/23 (PDF)

Stage 2 - Work Write-Up & Cost Estimate

Stage 3 - Bldg. Contractor Elig. Verif (XLSX)

Stage 3 - Pre Construction Form (XLS)

Stage 3 - Bid Certification (Optional) (XLS)

Stage 3 - Bid Tabulation (Optional) (XLS)

Stage 3 - Pre-Bid Walkthru (Optional) (XLS)

Stage 4 - Final Inspection (XLS)

Stage 4 - Administrator Certification of Energy Efficiency Rule Compliance (PDF)

Stage 4 - Request for Payment (XLS)

Stage 4 - Soft Cost Invoice (XLS)

Stage 4 - Interim Inspection (Optional) (XLS)

Stage 4 - Change Order Form (optional) (XLS)

Optional Forms

Zero Income and Zero Assets Certification (PDF)

Verification of Recurring Cash Contributions (PDF)

Employment Verification (PDF)

Verification of Asset (PDF)

Verification of Income from Business (PDF)

Verification of Social Security Benefits (PDF)

Verification of Pension and Annuities (DOC)

Verification of Veterans Administration Benefits (DOC)

Verification of Public Assistance Income (DOC)

Verification of Child Support Payments (DOC)

Verification of Income from Military Service (PDF)

Record of Phone Verification (PDF)

Photo Release Form (PDF)

Sample Approval Letter Template (DOC)

Sample Denial Letter Template (DOC)

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