The Texas Employment Verification form is a crucial document used by employers to confirm the employment status of individuals applying for state benefits. This form requires employers to provide specific details about the employee's job, pay, and other relevant information. To ensure a smooth process, it's essential to fill out the form accurately and return it promptly.
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When filling out the Texas Employment Verification form, there are important guidelines to follow. Here’s a list of things you should and shouldn't do:
Following these guidelines will help ensure a smooth and efficient 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.
Property Tax Reduction Texas - Submit applications annually between January 1 and April 30, unless exempted by specific circumstances.
Texas Medical License Verification - This form is used for verifying experience in the private security industry in Texas.
The Texas Employment Verification form is an essential document for confirming an individual's employment status, particularly in relation to state benefits. However, it is often accompanied by several other forms and documents that provide additional context or information. Below is a list of commonly used documents alongside the Texas Employment Verification form.
These documents work together to provide a complete picture of an individual's employment status and income, which is particularly important in contexts such as applying for state benefits or securing loans. Each document serves a unique purpose, ensuring that all necessary information is available for verification and assessment.
Filling out the Texas Employment Verification form can be straightforward, but many people make common mistakes that can delay processing. One frequent error is failing to provide complete information. The employer must fill out all required sections, including the employee's name, address, and details about their employment. Incomplete forms can lead to unnecessary back-and-forth communication, wasting time for both the employer and the employee.
Another mistake is neglecting to sign and date the form. The employer's signature is crucial as it confirms the accuracy of the information provided. Without a signature, the form may be considered invalid. This oversight can cause significant delays in the verification process, impacting the employee's access to state benefits.
Some employers mistakenly check the wrong employment status. It's essential to accurately indicate whether the employee is currently employed or has separated from the company. Mislabeling this status can lead to confusion and might require additional clarification, further complicating the process.
Additionally, employers often forget to indicate the type of job the employee held. This detail is important for the Texas Health and Human Services Commission to understand the nature of the employment. Omitting this information can result in delays, as the agency may need to reach out for clarification.
Another common error is failing to provide the correct rate of pay and how often the employee is paid. These details are vital for determining eligibility for certain benefits. Employers should ensure they provide accurate figures and clarify if the employee receives any additional compensation, such as tips or bonuses.
Moreover, some employers do not specify whether health insurance is available to the employee. This information is relevant for assessing the employee's overall compensation package. If this section is left blank, it may lead to further inquiries, prolonging the verification process.
Finally, not providing a clear explanation for any changes in employment status or pay can create confusion. If the employer anticipates changes in the near future, they should communicate this information clearly on the form. Transparency is key to ensuring that the verification process runs smoothly.
Misconceptions about the Texas Employment Verification form can lead to confusion and errors. Here are ten common misunderstandings explained:
Understanding these misconceptions can help ensure that the Texas Employment Verification form is completed accurately and efficiently, benefiting both employees and employers.
Filling out and using the Texas Employment Verification form can be straightforward if you keep a few key points in mind. Here are some essential takeaways to help guide you through the process:
By keeping these points in mind, both employers and employees can navigate the Texas Employment Verification form with ease and confidence.
Filling out the Texas Employment Verification form requires careful attention to detail. This form needs to be completed by your employer and returned to the Texas Health and Human Services Commission. The employer must provide accurate information regarding your employment status and earnings. Follow the steps below to ensure the form is filled out correctly.
Once completed, the employer can return the form by giving it to the employee, mailing it using the pre-paid envelope, or faxing it to the provided number. Ensure that all information is accurate to facilitate the verification process.