TAP Application

Personal Information
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Last 4 of you Social Security Number*
Eligible County of Residence*
Must be a Texas Resident in the 10-county DFW Region.
Do you have a valid Texas Diver's License?*

YesNo
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
example@example.com
Mobile Number*
Work Number
Vehicle Information
Texas License Plate Number*
Toll Tag / EZ Tag Number
Your tag number will be in one of the following formats: DFW.01234567 or DNT.12345567+ or HCTR1234567+ or former TxTags: TEX.1234567+
Vehicle Year*
ei: 1997, 2024
Vehicle Make*
Vehicle Model*
Primary Vehicle Color*
Is the Vehicle Registered Under the Applicants Name?*

YesNo
Owner Full Name

First NameMiddle NameLast Name
If NO, fill out vehicle owner information below:

Street Address

Street Address Line 2

CityState

Zip Code
Owner Telephone
Owner E-mail
example@example.com
Eligibility

Dial 211, for questions about any of these programs and eligibility status or contact your case worker.
Please select a program(s) you are currently participating in:*

SNAP: Supplemental Nutrition Assistance Program (formerly Food Stamps)WIC: Women, Infants, and Children Supplemental Nutrition ProgramTANF: Temporary Assistance for Needy Families programMedicaidCHIP: Children's Health Insurance ProgramSSI: Supplemental Security Income (Disability)Ryan White CARE Act Recipient
Should be Empty: