Fill Your Texas Employment Verification Form Launch Texas Employment Verification Editor Now

Fill Your Texas Employment Verification Form

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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Dos and Don'ts

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:

  • Do ensure all information is accurate and complete.
  • Do sign and date the form to validate the information provided.
  • Do use “N/A” for questions that do not apply to the employee.
  • Do return the form promptly to avoid delays in processing.
  • Don't leave any sections blank; this could lead to processing issues.
  • Don't provide false information, as this can have legal consequences.
  • Don't forget to check for any updates or changes in the employee's status before submission.

Following these guidelines will help ensure a smooth and efficient verification process.

Sample - Texas Employment Verification Form

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

Date

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

Yes

No

Frequently

Rarely

Never

Yes

No

Yes

No If yes, current value?

Health insurance available?

If yes, employee is:

 

 

 

Name of Insurance Company

Yes

No

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

 

Date

Title

Area Code and Phone No.

 

 

 

 

 

 

 

 

 

 

 

 

More PDF Templates

Documents used along the form

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.

  • W-2 Form: This form summarizes an employee's annual wages and the taxes withheld from their paycheck. Employers must provide this to employees by January 31 each year, making it a crucial document for verifying income.
  • Pay Stubs: These are issued with each paycheck and detail the employee's earnings, deductions, and net pay. They serve as proof of income and employment when applying for loans or benefits.
  • IRS Form 1099: For independent contractors or freelancers, this form reports income earned outside of traditional employment. It is essential for verifying income for those who do not receive a W-2.
  • Employment Offer Letter: This document outlines the terms of employment, including job title, salary, and start date. It can help establish the nature of the employment relationship.
  • Job Description: A detailed description of the employee's role and responsibilities. This document can clarify the type of work performed and the level of expertise required.
  • Verification of Employment (VOE) Letter: This letter is often requested by lenders or other entities to confirm an individual's employment status and income. It is typically written by the employer and includes relevant details about the employee's job.
  • State Benefit Application: When individuals apply for state benefits, they often submit this application, which may require proof of employment. It helps agencies assess eligibility for assistance programs.
  • Tax Returns: Personal tax returns can provide a comprehensive view of an individual's income over a year. They may be requested to verify income for loans or other financial assessments.
  • Social Security Administration (SSA) Earnings Record: This document provides a history of an individual's earnings reported to the SSA, which can be useful for verifying employment history and income.
  • Separation Notice: When an employee leaves a job, this notice outlines the reason for separation and can be important for unemployment claims or future employment verification.

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.

Common mistakes

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

Misconceptions about the Texas Employment Verification form can lead to confusion and errors. Here are ten common misunderstandings explained:

  1. Only current employees need verification. Many believe that this form is only for current employees. However, it can also be used for former employees when verifying past employment.
  2. The employer can fill out the form without the employee's consent. This is incorrect. The employee must agree to allow their information to be shared, as stated on the form.
  3. All employers are required to fill out this form. Not all employers are obligated to complete this form. It is specifically for employers of individuals applying for state benefits.
  4. Providing information is optional for the employer. While employers can choose to respond, providing accurate information is crucial for the employee's benefits application.
  5. The form is only for tax credits. Some think the form is only about tax credits. It also serves to verify employment for state benefits, which is a separate matter.
  6. Any employee can request this form. Only employees or former employees applying for state benefits can request that their employer complete this form.
  7. All information on the form is confidential. While the information is sensitive, it can be shared with the Texas Health and Human Services Commission for the purpose of verifying benefits.
  8. Employers can ignore questions that don’t apply. Employers should mark those questions with "N/A" instead of leaving them blank, as this clarifies the response.
  9. Submitting the form is the employer's responsibility only. Both the employer and the employee have roles in ensuring the form is completed and submitted correctly.
  10. There’s no deadline for submitting the form. There is a specific timeline for returning the completed form, which is essential for timely processing of benefits.

Understanding these misconceptions can help ensure that the Texas Employment Verification form is completed accurately and efficiently, benefiting both employees and employers.

Key takeaways

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:

  • Employer Responsibility: The employer is required to complete the form accurately. This ensures that the information provided is reliable and can be used for determining eligibility for state benefits.
  • Employee Consent: Employees must give permission for their employer to share their Social Security number and employment details. This consent is crucial for the verification process.
  • Completing the Form: Employers should fill out the "Proof of Employment" section thoroughly. If a question does not apply, it’s important to mark it as "N/A" to avoid confusion.
  • Submission Options: Once completed, the form can be returned in several ways: handed to the employee, mailed using the provided pre-paid envelope, or faxed to the designated number.
  • Accurate Reporting: Employers must ensure that all information, including wages and employment status, is reported truthfully. Any discrepancies can lead to complications in the benefits application process.

By keeping these points in mind, both employers and employees can navigate the Texas Employment Verification form with ease and confidence.

File Characteristics

Fact Name Details
Purpose The Texas Employment Verification form is used by employers to verify an employee's work status for state benefits.
Governing Law This form is governed by Texas state law, specifically related to employment verification for public assistance programs.
Required Information Employers must provide details such as employee name, address, job type, and rate of pay.
Submission Methods Employers can return the completed form by mail, fax, or directly to the employee.
Contact Information If assistance is needed, individuals can call 2-1-1 or 877-541-7905 for help.
Privacy Agreement Employees must consent to allow their Social Security number to be shared with the employer for verification purposes.
Health Insurance The form asks if health insurance is available to the employee and requires details about enrollment.
Final Check Information Employers must provide details about the final paycheck if the employee is no longer employed.

How to Use Texas Employment Verification

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.

  1. Start by entering the Name and Address of the employer at the top of the form.
  2. Provide the Date when the form is being filled out.
  3. Fill in the Case Name and Case No. as required.
  4. In the section that asks for the employee's information, write the Employee Name and Employee Address as shown in your records.
  5. Indicate if the employee is or was employed by marking Yes or No.
  6. If the answer is Yes, specify the type of job by selecting Full Time, Part Time, Permanent, or Temporary.
  7. Fill out the Rate of Pay section, indicating how much the employee earns per Hour, Day, Week, Month, or Job.
  8. Specify how often the employee is paid (e.g., weekly, bi-weekly).
  9. Complete the section on Average Hours Per Pay Period.
  10. Indicate if the employee receives Commissions, Tips, Bonuses, or Overtime Pay and whether FICA or FIT is withheld.
  11. State if there is a Profit Sharing or Pension Plan available, and if so, provide the current value.
  12. Indicate if health insurance is available and specify the Name of Insurance Company if applicable.
  13. Fill in the Date Hired and Date First Check Received.
  14. Provide the Average Hours Per Week worked by the employee.
  15. If the employee was on Leave Without Pay, indicate the Start Date and End Date.
  16. Answer whether you expect any changes to the information within the next few months.
  17. In the chart provided, list all wages received by the employee during the specified month(s), including details such as Date Pay Period Ended, Actual Hours, Gross Pay, and Other Pay.
  18. Add any necessary comments regarding tips, commissions, or bonuses in the comments section.
  19. If the employee is no longer employed, fill in the Date Separated, Reason for Separation, and Date Final Check Received.
  20. Finally, the employer must read the declaration, sign, and date the form, including their title and contact number.

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.