Purpose: To request domicile verification from a nonrelative who is familiar with the household's situation. There's an application for title that you'll need to fill out as well called Form 130U.Please list all of the persons living in the home, including the client named on the front of this form: Name. Relationship to Client. 1. Collect all necessary documentation supporting your domicile claim. Form to apply for Food Benefits (SNAP), Healthcare (Medicaid and CHIP), or cash help for families (TANF) (H1010). This form is used to verify housing information for Texas Health and Human Services. List of recommended items to bring when living on campus at the University of Texas at Austin.