Purpose: To request domicile verification from a nonrelative who is familiar with the household's situation. Please list all of the persons living in the home, including the client named on the front of this form: Name.Relationship to Client. This form is used to verify housing information for Texas Health and Human Services. To establish a new domicile, you need 1) a physical presence, and 2) a truthful, concurrent, intent of making the new state your permanent place of abode. The letter is worded to the outside person not to you. We provide a broad range of services and information through our website.