Identity Recovery Service Contract Providers and Administrators Forms

These forms are available for download in Adobe Acrobat .pdf format. Acrobat Reader is necessary to view .pdf files. If you need to obtain a copy of this program it is available as a free download for Windows or Macintosh operating systems.

Please note the following policy regarding the filing of forms which collect a person's individual information:

"An individual who completes and files this form with the Texas Department of Licensing and Regulation (the Department) is entitled to the following from the Department:

(1) to be informed about the information that the Department collects about the individual, upon the request of the individual and subject to a few exceptions;

(2) to receive and review the information, under Sections 552.021 and 552.023 of the Texas Government Code; and

(3) to have the Department correct information about the individual that is incorrect, under Section 559.004 of the Texas Government Code."

Form IDR001, Provider Registration (35 kb download)

Form IDR002, Provider Registration Instructions (17 kb download)

Form IDR003, Administrator Registration (30 kb download)

Form IDR004, Administrator Registration Instructions (15 kb download)

Form IDR005, Biographical Affidavit (34 kb download)

Form IDR006, Biographical Affidavit Instructions (13 kb download)

Form IDR007, Provider Registration Checklist (42 kb download)

Form IDR008, Provider Quarterly Contract Fee Report (30 kb download)

Form IDR009, Provider Texas Endorsement (24 kb download)

Criminal History Questionnaire (69 kb download)

Criminal History Evaluation Letter

Disciplinary Action Questionnaire (13 KB download)