The Texas Employment Verification Form, a crucial document managed by the Texas Health and Human Services Commission, is designed for employers to confirm an employee's or former employee's employment status, earnings, and other job-related information. This form plays a significant role for individuals applying for state benefits, as it can influence eligibility and the level of assistance provided. Employers complete and return it, thus facilitating the verification process for various state assistance programs.
To ensure a smooth verification process and aid in the timely provision of state benefits, fill out the Texas Employment Verification form today by clicking the button below.
In Texas, navigating the complexities of employment verification can seem daunting for both employers and employees alike. However, the Texas Employment Verification Form plays a crucial role in this process, serving as a bridge between employees, their employers, and the Texas Health and Human Services Commission. Primarily, this document is designed to authenticate the employment status and earnings of individuals applying for or receiving state benefits, thereby ensuring the accuracy and integrity of the information provided to the state. To facilitate this, the form requires comprehensive details about the employee in question, including their social security number, employment status (whether current or former), and the nature of their job. Employers are tasked with verifying these details, which may include the rate of pay, type of employment (e.g., full-time, part-time, temporary, or permanent), and any additional income like commissions, tips, or bonuses. Additionally, the form explores the availability of health insurance and participation in profit-sharing or pension plans, underlining the state's commitment to a thorough review process. Information about the employee's earnings, including gross pay and other pay, is meticulously outlined for a specific period, highlighting the form's role in ensuring that state benefits are accurately allocated based on verifiable employment data. The inclusion of support options—such as contact numbers for assistance and instructions for the form’s submission—underscores the state’s dedication to accessibility and user guidance throughout the verification process.
Name and Address
Date
Need help? Call 2-1-1 or 877-541-7905.
Fax: 877-447-2839
Mail:
Texas Health and Human Services Commission
P O BOX 149027
Austin, Texas 78714-9027
If you are deaf, hard of hearing, or speech impaired, call 7-1-1 or 800-735-2989. All numbers are free to call.
Case Name
Case No.
This form is for your employer. They need to fill out the form and return it by. You must agree to let them give facts about you.
Fill Out and Sign This Agreement
I,
(print your name) allow HHSC to give my Social Security number (SSN) to the employer listed on this form.
My SSN can be used to get facts about my employment. I also allow the employer listed on this form to give facts asked on this form to HHSC.
Signature
Employer – Your Help Is Needed
Employee or Former Employee
Social Security No.
We need proof that the following person is or was your employee.
Some employers might get tax refunds or tax credits for hiring people who get certain state benefits.
To learn more, go to TexasWorkforce.org/wotc or email the Texas Workforce Commission at wotc@twc.state.tx.us.
Employer please follow these steps.
This person lives in a home in which someone is applying for state benefits. We need to know the amount of money this person makes or made from this job.
1.Please fill out the “Proof of Employment” form on the next page.
2.If a question doesn't apply, mark it with "N/A."
3.Return the form:
To send this back to us, you can either:
(a)give it to the employee listed above,
(b)mail it in the pre-paid envelope, or (c) fax it to 877-447-2839.
Form H1028 / 07-2022
Employment Verification
Form H1028
Page 2 / 07-2022-E
Proof of employment to be filled out by the employer.
Company or Employer
Address (Street, City, State, ZIP code)
Employee Name (as shown on your records)
Employee Address (Street, City, State, ZIP Code – as shown on your records)
Is (or was) this person employed by you?
If yes, what type of job?
Yes
No
Full Time
Part Time
Permanent
Temporary
If no: Stop here – sign and date the bottom of this form and return it.
If yes: Answer all the questions below. If a question doesn’t apply, write “N/A".
Rate of Pay
Per Day
Per Week
Per Month
Per Job
Per Hour
How Often Paid?
Average Hours Per Pay Period
Commissions Tips Bonuses
Overtime Pay
FICA or FIT Withheld
Profit Sharing or Pension Plan
Frequently
Rarely
Never
No If yes, current value?
Health insurance available?
If yes, employee is:
Name of Insurance Company
Not Enrolled
Enrolled with Family Member
Enrolled for Self Only
Date Hired
Date First Check Received
Average Hours Per Week
If Employee
is or was on Leave Without Pay:
Start Date:
End Date:
Do you expect any changes to the above information within the next few months? Yes No
If yes, explain:
On the chart below, list all wages received by this employee during the month(s) of:
Date Pay
Period Ended
Date Employee
Received Paycheck
Actual Hours
Gross
Pay
Other Pay*
(tips, commissions, bonuses)
EITC
Advance
Total Pretax
Contributions
*Please explain (in comments section below) when and how often tips, commissions, or bonuses are received. Comments
If this person is no longer in your employ.
Date Separated
Reason for Separation
Date Final Check Received
Gross Amount of Final Check
Employer – Read, Sign and Date
I confirm that this information is true and correct to the best of my knowledge:
Employer Signature
Title
Area Code and Phone No.
Filling out the Texas Employment Verification form is a crucial step for employees undergoing processes that require them to prove their employment status or income in the State of Texas. This document serves as a formal verification from the employer about the employee's work and is often needed for various state benefits applications. Ensuring accuracy and completeness while filling out this form is necessary to avoid delays or issues with your application. Here's a simple guide to help you through the process.
After the form is completed and submitted, the Texas Health and Human Services Commission will process the information for the specific benefits or services you're applying for. The completion of this verification step is crucial for the continued progression of your application. Make sure to keep a copy of the completed form for your records and follow up as necessary to ensure that your application proceeds smoothly.
The Texas Employment Verification Form, also known as Form H1028, is a document used by employers in the state of Texas to verify the employment status and income of individuals who are applying for or receiving state benefits. This form is required by the Texas Health and Human Services Commission (HHSC) to help determine the eligibility of applicants for various state-supported aid programs.
This form is intended for employers. It should be completed by them to provide necessary information about an employee's or former employee's employment status, income, and other related details as part of the employee's application for state benefits.
An employee gives their consent by filling out and signing the agreement section of the form. This section requires the employee to print their name, provide their Social Security number (SSN), and sign the document. By doing this, the employee allows the HHSC to share their SSN with their employer and permits the employer to release their employment and income information to the HHSC.
If the individual in question is no longer employed by the employer, the employer should indicate "No" to the question of current employment, sign and date the bottom of the form, and return it without answering the further questions. They should also provide the date of separation and reason for separation if applicable.
Yes. Some employers might be eligible for tax refunds or credits for hiring individuals who receive certain state benefits. Employers can learn more about these potential benefits by visiting TexasWorkforce.org/wotc or contacting the Texas Workforce Commission via email at wotc@twc.state.tx.us.
Yes. The form asks employers to specify whether health insurance is available to the employee, if the employee is enrolled in a plan, and what type of enrollment it is (e.g., self-only, family member, not enrolled). If health insurance is available, the employer must also provide the name of the insurance company.
If the employer anticipates any changes to the employment or income information provided within the next few months, this should be indicated on the form with a "Yes" response to the relevant question. The employer is also asked to explain what changes are expected.
When filling out the Texas Employment Verification form, it’s crucial to avoid common mistakes that can delay processing. Below are nine common errors:
Below are additional tips to ensure accuracy and completeness:
Avoiding these mistakes not only expedites the process but ensures that employees receive the correct benefits in a timely manner.
When processing employment verification in Texas, it's important to consider the broader context of employment and human resources documentation. The Texas Employment Verification Form provides critical employment history and income information. However, several other forms and documents play essential roles in ensuring that both employers and employees meet their legal and procedural obligations. These documents support various aspects of employment, from hiring to potential termination, and help facilitate compliance with state and federal regulations.
Together with the Texas Employment Verification Form, these documents contribute to a comprehensive employment records package. They help manage the employment lifecycle, from onboarding to departure, ensuring both regulatory compliance and a clear communication pathway between employers and employees. Knowing and using these forms appropriately not only protects the organization but also supports the rights and responsibilities of its workforce.
The Form I-9, Employment Eligibility Verification, required by the U.S. Citizenship and Immigration Services (USCIS), bears strong resemblance to the Texas Employment Verification form in its objective to verify an individual's employment eligibility in the United States. Both forms necessitate the provision of personal identification and employment details, albeit for different end goals: the Form I-9 for verifying the legal status of employees to work in the U.S., and the Texas form primarily for determining eligibility for state benefits or tax credits for employers.
A W-4 form, used by employers to determine the correct amount of federal income tax to withhold from employees' paychecks, shares similarities with the Texas Employment Verification form in the sense that both require employee information and are integral to financial and employment verification processes. The key difference lies in their primary usage: the W-4 focuses on tax withholding preferences, while the Texas form focuses on verifying employment for state benefit eligibility.
The verification process in the Texas Employment Verification form also parallels the procedures required by the Request for Verification of Employment (VOE) form used in mortgage lending. A VOE form substantiates an applicant's employment status and income, which lenders need to assess loan suitability and risk, similar to how the Texas form verifies employment for state benefits or tax credits.
The Employee’s Withholding Certificate for Local Taxes, often required in certain jurisdictions for local tax withholding, and the Texas Employment Verification form serve similar administrative functions in gathering employee identity and employment details. While the focus of the local withholding certificate is on local tax implications, both documents are pivotal in ensuring the correct management of employment-related fiscal responsibilities.
Another document akin to the Texas Employment Verification form is the Employer's Quarterly Federal Tax Return, known as Form 941, which employers use to report income taxes, social security tax, or Medicare tax withheld from employee's paychecks. Both forms are essential for tax reporting and compliance, although the Texas form specifically aids in verifying employment for employees applying for state benefits, rather than fulfilling federal tax obligations.
The Unemployment Insurance (UI) Wage Verification form, essential for verifying wages for UI benefits claims, mirrors the functionality of the Texas Employment Verification form. Both are crucial in determining an individual's financial eligibility for certain benefits, yet they cater to different types of benefits, with one focusing on unemployment benefits and the other on state benefits like food or healthcare assistance.
Similarly, the Proof of Income Statement (Option "C" Print) from the Canada Revenue Agency, which verifies an individual's income for a variety of purposes, shares the function of confirming employment and income details like the Texas Employment Verification form. Though one is specific to Canadian residents for a broad array of verification purposes and the other serves residents of Texas for state benefits, both streamline the verification of employment and financial status.
Last, the Direct Deposit Enrollment Forms that many employers use for setting up electronic paycheck deposits also require detailed employee identification and banking information, somewhat similar to the Texas Employment Verification form. While primarily for facilitating salary payments, both forms necessitate employer verification of employee details, underscoring the importance of accuracy in personal and employment information across administrative purposes.
When filling out the Texas Employment Verification form, accuracy, and attentiveness to detail are paramount. In the context of ensuring that all parties are accurately represented, and legal obligations are met satisfactorily, certain practices should be followed diligently, while others should be avoided. Below are systematic guidelines that highlight these practices:
Do's:
Don'ts:
When it comes to the Texas Employment Verification form, there are several misconceptions that can lead to misunderstandings for both employers and employees. Let's clear up some of these misconceptions to ensure you're fully informed.
Only Texas-based employees need to be verified: This form is relevant for any employee working in Texas, regardless of their state of residency. Employers must verify employment for any individual employed within the state.
It's optional for employers: Completing the Texas Employment Verification form is not optional. When requested, employers are required to fill it out to comply with state benefit program requirements.
The form is complex and time-consuming: While the form requires detailed information, it is structured in a straightforward manner. Employers should find it relatively easy to complete if they have their employment records organized.
Employers must know the employee's Social Security Number (SSN) by heart: While the form does ask for the employee's SSN, employers typically reference their records rather than recalling this information from memory.
The form only benefits employees: The form can also benefit employers, as it can help them qualify for tax refunds or credits for hiring individuals receiving certain state benefits.
All questions must be answered fully: If a question is not applicable, employers can simply mark it with "N/A" (not applicable). The form is designed to accommodate varying employment situations.
Employers can keep the information private: By signing the form, employers agree to share the specified information with the Texas Health and Human Services Commission (HHSC). Privacy is maintained within the boundaries of the law, but relevant employment information must be disclosed.
It's a one-time verification: Employers might need to complete the form multiple times if they hire several employees who are applying for state benefits or if re-verification is requested by the state.
Any method of return is acceptable: The form clearly outlines acceptable methods of return, including mailing it in the pre-paid envelope provided or faxing it to the specified number. Handing it to the employee is also an option, but the form must reach HHSC in one of the approved ways to be processed correctly.
Understanding these key points about the Texas Employment Verification form ensures that both employers and employees can navigate the process with confidence, fulfilling legal obligations while supporting eligibility for state benefit programs.
Understanding the Texas Employment Verification Form is crucial for both employers and employees engaged in the employment verification process. Here are seven key takeaways to ensure the process is handled accurately and efficiently:
By following these guidelines, both employers and employees can navigate the Texas Employment Verification process more smoothly, ensuring that all parties fulfill their obligations and contribute to an accurate assessment of state benefit eligibility.
Texas Engineer - The Board requires the examination to ensure engineers are equipped with knowledge of their responsibilities towards the public and the profession.
Texas Credentialing Application - Enables providers to document their eligibility and standings with regard to board certifications.
Free Divorce Papers in Texas - Clarification that divorce in Texas hinges on residency and county filing requirements serves as a crucial reminder of the jurisdictional aspects of legal dissolution of marriage.