Though the preferred method for obtaining a birth certificate is through the regional eligibility specialist, a CPS caseworker or designee (such as a unit administrative assistant) may need to use personal funds to purchase a certified birth certificate from the Department of State Health Services or from an out-of-state agency.

To request reimbursement for the purchase of a certified birth certificate, the CPS worker:

• Completes a Form 4116 State of Texas Purchase VoucherWord Document.
• Enters his or her name, address (home or office), and Social Security number as the vendor number.
• Ensures the forms have the worker and supervisor’s signatures;  
• Includes the receipt of purchase.
• Submits the completed form and receipt to the CPS budget analyst at state office mail code E-669.

Forms may not be e-mailed to budget analysts. If an employee is not in the same office as the supervisor, he or she may fax the form to the supervisor for his or her signature. An employee may submit more than one family per voucher as long as he or she differentiates between families and dates of purchase.