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Waiver of Gas Service Deposit Letter for Victim of Family Violence

Texas · TexasLawHelp.org

This letter is used by a victim of family violence to help prove they are eligible to get gas service without having to pay a deposit. A service provider, medical person, law enforcement, or the Attorney General's designee must complete and sign this letter.

The court describes it as: A victim of family violence can use this letter to establish gas service.

Open the official PDFfrom TexasLawHelp.org

Where this fits in a case

General & info

Information / general use — not tied to one step of a case

This letter is used when a victim of family violence needs to establish gas service and needs to waive the usual deposit requirement. The signed original must be given to the gas company when applying for new service.

Either party may file.

Common questions

Who fills out this letter?
A family violence center staff member, treating medical personnel, law enforcement agency personnel, or a designee of the Attorney General can complete this letter.
What does this letter prove?
It proves that the named applicant is a victim of family violence as defined by Texas Family Code §71.004.

Revision history

No changes recorded since we started tracking this form on October 9, 2026.

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