Modify Texas Employment Verification Here

Texas Employment Verification Form in PDF

The Texas Employment Verification form, formally recognized as Form H1028, serves a vital role in ensuring accurate employment information is relayed to the Texas Health and Human Services Commission (HHSC). This document is crucial for employers as it demands a detailed account of an employee's or former employee's work status, income, and other pertinent details that may affect state benefit applications. It embodies a bridge between employment records and state assistance programs, streamlining the verification process for both parties involved.

To ensure compliance and aid in the seamless processing of state benefits, timely and accurate completion of the Texas Employment Verification form is imperative for employers. Click the button below to start filling out the form right away.

Modify Texas Employment Verification Here

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In the intricate landscape of employment and benefits within Texas, the Employment Verification Form, denoted as Form H1028, emerges as a pivotal document designed to streamline the verification process for employees seeking to qualify for state benefits. This form serves as a bridge between employers, employees, and the Texas Health and Human Services Commission (HHSC), ensuring accurate and efficient communication regarding an individual's employment status and earnings. Individuals are required to authorize the disclosure of their Social Security number (SSN) to their employer via the form, thereby permitting their employer to furnish details about their employment directly to HHSC. The form meticulously requests data from employers about the employee's employment status—whether current or former—alongside specifics such as job type, rate of pay, benefits, and any changes anticipated in the near future. Additionally, it touches on tax incentives for employers through certain hires, underscoring the form's broader relevance to Texas's workforce development strategy. Through this structured approach, the form not only facilitates the application process for state benefits by providing a standardized method for employment verification but also highlights the interconnectedness of employment practices with social welfare programs in Texas.,

Texas Employment Verification Sample

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.

⇩ PDF File

File Characteristics

Fact Name	Description
Governing Law	The Texas Employment Verification form is governed by the laws and regulations of the state of Texas, specifically under the oversight of the Texas Health and Human Services Commission.
Form Identification	This form is identified as Form H1028, with an edition for July 2022 provided for employment verification purposes.
Primary Purpose	The main goal of this form is to verify the employment status and income of individuals applying for or receiving state benefits, aiding the Texas Health and Human Services Commission in determining eligibility.
Contact Information	For assistance with the form, individuals can contact the Texas Health and Human Services Commission via phone at 2-1-1 or 877-541-7905, use a fax number 877-447-2839, or mail at P.O. BOX 149027, Austin, Texas 78714-9027.

Detailed Guide for Writing Texas Employment Verification

The Texas Employment Verification form plays a crucial role for individuals applying for state benefits. It requires employers to verify employment details to help determine eligibility for state benefits, potentially including tax refunds or credits for the employer. This simple step-by-step guide is here to make the process easy and straightforward, ensuring that all necessary information is accurately conveyed.

Start by having the employee needing verification fill out the top section of the form. They should print their name and provide their Social Security number (SSN), allowing the Texas Health and Human Services Commission (HHSC) and the employer to use it for verification purposes.
The employee must sign and date the form to give their consent for this process.
Employers should then proceed to the "Proof of Employment" section, adding the company or employer address and employee name as recorded in their files.
If the person is or was employed with your company, indicate whether the job was full-time, part-time, permanent, or temporary. If the person was not employed, mark "No," sign, and date the form at the bottom, then return it.
For current or past employees, fill out the rest of the form, including rate of pay, how often they are paid, average hours per pay period, and any additional compensation like commissions, tips, and bonuses.
Answer questions about available benefits, such as health insurance, and provide enrollment details if applicable.
Include the date hired, date of the first paycheck received, average hours worked per week, and leave without pay details if relevant.
State whether any changes to the provided information are expected in the next few months. If yes, give a brief explanation.
Complete the chart with wage details for the specified month(s), including pay period end dates, paycheck receipt dates, actual hours worked, gross pay, and other pay details.
For employees no longer with the company, fill out the separation date, reason for separation, final check receipt date, and gross amount of the final check.
The employer should read the declaration at the bottom of the form, confirming the information provided is true and accurate, then sign and date the form.
Return the completed form by giving it to the employee, mailing it using the pre-paid envelope, or faxing it to 877-447-2839.

Once the form is completed, it will be processed to assist with the evaluation of state benefit eligibility. This straightforward process not only supports the employee's application but can also benefit employers through potential tax advantages.

Common Questions

What is the Texas Employment Verification Form?

The Texas Employment Verification Form, known as Form H1028, is a document used by the Texas Health and Human Services Commission (HHSC) to verify employment information of individuals applying for or receiving state benefits. This form requires employers to provide detailed information about an employee's job status, income, and benefits. It helps ensure that applicants receive the correct level of assistance based on their employment situation.

Who needs to fill out this form?

This form should be completed by the employer of an individual who is applying for or receiving state benefits in Texas. It is crucial for the employer to provide accurate and comprehensive information about the employee's work and income to help the state determine the applicant's eligibility and benefit levels.

How can the form be submitted?

There are three ways to submit the completed Texas Employment Verification Form:

The employer can give the completed form directly to the employee to submit.
The form can be mailed to the Texas Health and Human Services Commission at the address provided on the form.
Alternatively, the form can be faxed to 877-447-2839.

What information does the employer need to provide?

The employer is asked to fill out various sections of the form, including:

Company or employer address and contact information
Employee's name, address, and Social Security Number
Employment status (e.g., full-time, part-time, temporary, permanent)
Rate of pay, how often paid, average hours per pay period
Available benefits such as health insurance, profit sharing, or pension plans
Information on wages received by the employee, including any other pay like tips, commissions, or bonuses

What if an employer has questions about completing the form?

Employers who have questions or need assistance with filling out the form can call 2-1-1 or 877-541-7905 for help. Assistance is also available for those who are deaf, hard of hearing, or speech impaired by calling 7-1-1 or 800-735-2989. These services aim to provide support and ensure the form is filled out correctly to avoid any delays in processing state benefits.

Common mistakes

When completing the Texas Employment Verification form, several common mistakes are often made. These errors can lead to delays or issues in processing the form, affecting the timely accrual of state benefits. Here is a list of mistakes to avoid:

Not double-checking for accuracy: Information about the employee, such as the Social Security Number (SSN) and employment details, must be verified for accuracy to avoid discrepancies.
Skipping sections: Some employers may inadvertently skip sections that don't seem immediately relevant. Every question should be addressed, marking "N/A" where not applicable.
Omitting the date of hire and separation: The form requires the dates of hiring and, if applicable, separation. Omission of these dates can result in incomplete verification.
Incorrect rate of pay: Accurately recording the rate of pay, including whether it's per hour, day, week, month, or job, is crucial, as it affects benefits calculation.
Failing to list all forms of compensation: Employers should include all forms of compensation such as bonuses, commissions, and tips, as these contribute to the total earnings.
Neglecting to mention health insurance availability: Indicating whether health insurance is available to the employee and if they are enrolled is required information.
Forgetting to sign and date the form: The form is not complete without the employer’s signature and the date, affirming the accuracy of the provided information.
Delay in returning the completed form: Timely submission of the form is necessary. Choosing the most efficient return method (mail, fax, or directly to the employee) and acting promptly prevents delays in processing.

Avoiding these mistakes ensures the verification process is smooth and efficient, thus aiding employees in their application for state benefits efficiently and without unnecessary hindrance.

Documents used along the form

When managing employment in Texas, the Texas Employment Verification form (Form H1028) plays a crucial role in confirming an individual's employment status, particularly for those applying for or receiving state benefits. This verification process is integral to ensuring accurate eligibility decisions for various state aid programs. However, this form is just one piece of the documentation puzzle employers and employees might encounter. To provide a comprehensive understanding, here's an overview of other forms and documents often used alongside the Texas Employment Verification form.

W-4 Form (Employee’s Withholding Certificate): Used by employers to determine the federal income tax to withhold from an employee's paycheck. It ensures taxes are accurately withheld according to the employee's financial situation.
I-9 Form (Employment Eligibility Verification): A mandatory form that verifies an employee's eligibility to work in the United States. It requires documentation that confirms the employee's identity and legal work status.
Direct Deposit Authorization Form: Allows employees to provide their banking details to employers for direct deposit of paychecks, ensuring a more efficient and secure transfer of wages.
State New Hire Reporting Form: Employers are required to report new hires to a state directory within a short period after the hire date. This form aids in enforcing child support orders.
Employee Handbook Acknowledgment Form: A document where employees acknowledge they have received, read, and understood the company's employee handbook. It helps clarify company policies and expectations.
Job Application Form: Used by potential employees to apply for open positions. It collects information on the applicant's experience, skills, and background.
: Employers may require this form to pre-approve overtime work, helping in labor cost management and compliance with labor laws.

Termination Record: Documented evidence of an employee's termination, including reasons for the departure and the date of separation. This document is crucial for clarity during unemployment claims or legal disputes.

Together, these documents create a comprehensive framework for employment verification, tax compliance, and legal adherence in the Texas workforce. While the Employment Verification form is a starting point for confirming employment status, the additional documents ensure a thorough and compliant employment process, safeguarding both employers and employees. Keeping these documents in order ensures a smoother employment relationship and aids in meeting state and federal compliance requirements.

Similar forms

The Federal I-9 Employment Eligibility Verification form shares significant similarities with the Texas Employment Verification form. Both forms are designed to confirm an individual's eligibility for employment within an organization. The I-9 form requires document proof of an employee's legal right to work in the United States, while the Texas form focuses on verifying the employment status and income details for state benefits eligibility. Despite different purposes, both aim to validate employment-related information.

W-4 forms, commonly used by employers to determine the federal tax withholding from an employee's paycheck, also bear resemblance to the Texas Employment Verification form. While the Texas form seeks information regarding an employee's income for benefit purposes, the W-4 form collects data to assess federal tax obligations. Both forms involve employer participation in detailing aspects of an employee's financial compensation, emphasizing the importance of accurate financial documentation in employment and tax matters.

The Employment Eligibility Verification form for Work Opportunity Tax Credit (WOTC) mirrors aspects of the Texas Employment Verification form by requiring employer verification of an employee's status. The WOTC form serves to identify eligibility for employer tax credits when hiring individuals from certain target groups, demanding specific employment and income information. Like the Texas form, it underscores the intersection of employment verification and financial incentives in the workforce.

State-specific New Hire Reporting forms, which employers use to report newly hired or rehired employees to a statewide directory, share commonalities with the Texas Employment Verification form. Both tools assist in ensuring employees are accurately reported for state benefits, child support enforcement, and employment eligibility purposes. They contribute to a system of accountability and support in the employment landscape, despite serving slightly different administrative functions.

The Request for Verification of Employment (VOE) form used in the mortgage and lending industry also parallels the Texas Employment Verification form. Lenders use the VOE to confirm an applicant's employment and income stability when assessing loan eligibility. Both the VOE and the Texas form are integral in processes that require validation of an individual’s employment status and financial income, facilitating decisions based on documented proof of employment and earnings.

Unemployment insurance claim forms, crucial for individuals seeking unemployment benefits, align with the purposes of the Texas Employment Verification form in confirming past employment and earnings. Both forms collect data on employment history, earnings, and separation circumstances, playing a pivotal role in determining eligibility for financial support services. Through systematic verification, they ensure that benefits are allocated to qualified individuals based on accurately reported employment information.

Workers' Compensation forms, required when an employee gets injured on the job, necessitate employer verification of employment details akin to the Texas Employment Verification form. While focusing on different aspects—workers' compensation emphasizes injury and insurance claims—they both require detailed employer attestates regarding an employee's work status, highlighting the diverse needs for employment verification across various legal and health-related contexts.

Child Support Verification forms, employed to ascertain income details for child support purposes, reflect similar objectives to the Texas Employment Verification form. Both are geared towards using verified employment information to make informed decisions regarding financial responsibilities—in this case, for child support calculations. They underscore the role of employment verification in securing and enforcing financial obligations for dependents.

Lastly, the Request for Employment Information by Social Security Administration mimics the Texas form's aim by validating employment to ensure accurate Social Security benefits. This form is pivotal in establishing a record of an individual’s income and employment history, similar to how the Texas form confirms employment for state benefit eligibility. Each serves a crucial function in the broader context of governmental benefit programs, requiring detailed employer verification to uphold the integrity of benefits administration.

Dos and Don'ts

When completing the Texas Employment Verification form, there are several key practices to follow and avoid ensuring that the process is conducted smoothly and accurately. Here are eight critical dos and don'ts:

Do ensure all the information provided is accurate and truthful. Misinformation can lead to unnecessary complications.

Don't guess on any details. If unsure, it's crucial to verify the information before submitting the form.

Do print clearly in ink when filling out the form manually to ensure that all the information is legible.

Don't leave any applicable fields blank. If a question does not apply, it's important to mark it with "N/A" instead of leaving it empty.

Do pay attention to detail when providing dates, such as the date of hire, pay periods, and the date the form is signed.

Don't forget to sign and date the form as the employer. An unsigned form may be considered incomplete and could be rejected.

Do return the completed form by the preferred method of the Texas Health and Human Services Commission, whether that is by mail, fax, or directly to the employee.

Don't underestimate the importance of privacy. Ensure that the Social Security Number (SSN) and other personal information are handled securely throughout this process.

By following these guidelines, employers can contribute to the efficiency and integrity of the employment verification process, aiding both the employee and the Texas Health and Human Services Commission in their respective roles.

Misconceptions

When discussing the Texas Employment Verification form, it's crucial to address some common misconceptions and clarify them for better comprehension and compliance:

Only for Current Employment: Many believe this form is solely to verify current employment, which is a misconception. It's equally important for confirming past employment, essential for individuals applying for state benefits who may need to showcase their employment history.

Employer's Responsibility to Initiate: There's a misunderstanding that employers must initiate completing this form. In fact, it is the responsibility of the employee or former employee to provide this form to their (former) employer, indicating consent for employment verification.

Limited Use of Social Security Number (SSN): Some are under the impression that the SSN provided could be used for purposes beyond employment verification. The form clarifies that the SSN is specifically for obtaining employment facts, respecting privacy and ensuring data protection.

Complicated Process: A common myth is that the process is overly complicated. While it requires accuracy, the steps outlined on the form are straightforward, guiding both employee and employer through the process efficiently and effectively.

Benefits Determination is Instant: There's a misconception that once this form is submitted, decisions regarding state benefits or tax credits are made immediately. However, the information provided helps in the evaluation process, which may take some time before any determination regarding benefits or credits is made.

Understanding these aspects helps both employees and employers handle the Texas Employment Verification form with more clarity and ensures a smoother process for all parties involved.

Key takeaways

The Texas Employment Verification form is a crucial document for employees seeking state benefits, as it provides the Texas Health and Human Services Commission (HHSC) with necessary employment and income details. Understanding how to correctly fill out and use this form is essential for both employees and employers. Here are five key takeaways to guide you through the process:

Employee Authorization: Employees must provide consent for the release of their employment information to HHSC. This is done by filling out the initial section of the form, where the employee must print their name, provide their social security number (SSB), and sign the form, thereby allowing their employer to share employment facts with HHSC.

Employer Responsibility: Employers play a vital role in this process, as they are required to complete the "Proof of Employment" portion of the form. It's essential for employers to fill out the form accurately, providing comprehensive details about the employee's wages, type of employment, and benefits, among other information.

Completing the Form: When completing the form, it’s important to address each query. If certain questions do not apply, marking them with "N/A" (not applicable) helps maintain clarity and ensures the form is fully completed without leaving any sections blank.

Form Submission: There are several ways to return the completed form to HHSC. Employers have the option to give it directly to the employee, send it via mail using a pre-paid envelope, or fax it to the number provided. This flexibility ensures the information can be submitted in a timely and convenient manner.

Impact on State Benefits: Accurate employment verification is essential for individuals applying for state benefits, as it helps determine their eligibility and the level of assistance they qualify for. Employers should also be aware that providing proof of employment can be beneficial, as hiring individuals who receive certain state benefits might qualify the employer for tax refunds or credits.

For both employees and employers, timely and accurate completion of the Texas Employment Verification form is essential. It not only facilitates the process of applying for state benefits but also supports compliance with Texas employment verification laws.

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