Please rate Form H1049 Medicaid H1049 December 2015-E
Self-employment income is any money you make working for yourself or as a subcontractor. If you have an employer who pays you and takes out taxes, you're not self-employed.
Who must sign: the form must be signed by the person getting self-employment income or their spouse or authorized representative.
Anyone who helps: anyone can help you fill out the form, but that person also must sign this form.
More sheets: use more sheets of paper if you need to; you must sign and date each sheet.
Income to list: money from self-employment from the past 2 months; if you don't get paid every month, your most recent payments.
| Question | Answer |
|---|---|
| Form Name | Form H1049 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 97 |
| Avg. time to fill out | 17 min |
| Edition | December 2015-E |
| Who signs | The person getting self-employment income or their spouse or authorized representative |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | H1049, Form H1049, Form 1049, Texas H1049, Facts About Self-Employment Income |
| Official source | Form H1049 (Rev December 2015-E), Texas Health and Human Services Commission |
Form H1049 Medicaid isn’t the one you’re looking for?
Please rate Form H1049 Medicaid H1049 December 2015-E
