The Texas Employment Verification Form, known informally as Form H1028, serves as a critical tool for the Texas Health and Human Services Commission (HHSC) to confirm the employment details of individuals applying for state benefits. This comprehensive form, which must be filled out by employers, plays a key role in determining eligibility for various programs by verifying employment status, income, and other pertinent information. If you're navigating the process of applying for state benefits or are an employer required to complete this verification, consider clicking the button below to ensure you fill out the form correctly and expediently.
The Texas Employment Verification Form, pivotal for both employers and employees within the state, serves as a structured means to confirm an individual's employment status and income details. Required in situations where individuals or families apply for state benefits, this form plays a critical role in the benefits application process by verifying an employee's financial eligibility. Through this document, employers are asked to furnish comprehensive details about the employment status, type of job, payment specifics including rate and frequency, benefits like health insurance, and any expected changes to the employment situation. Notably, it emphasizes the importance of accuracy and honesty by necessitating an employer's signature to affirm that the information provided is true and correct. Furthermore, the form accommodates for those with disabilities by providing contact numbers for assistance and also highlights potential tax advantages for employers through certain hires. In essence, this form facilitates a smoother interaction between the state's health and human services and the workforce, ensuring that aid reaches those who are truly in need based on verified employment information.
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 takes a bit of attention to detail but is straightforward if you follow the steps below. This process is designed to verify employment information critical for state benefits eligibility. Both the employee and employer play vital roles in completing and submitting this form accurately and timely. Let's break down the steps needed for both parties to ensure the form is filled out properly.
Once completed, ensuring the form's accuracy and prompt submission will facilitate the necessary verification process for state benefits eligibility. Employers are encouraged to provide comprehensive details to support their employee's application, and employees should double-check the form for completeness before and after the employer fills it out.
What is the Texas Employment Verification form?
The Texas Employment Verification form, also known as Form H1028, is a document used by the Texas Health and Human Services Commission (HHSC) to verify employment information for individuals applying for or receiving state benefits. Employers are requested to provide details about an employee or former employee's job status, wages, and other relevant information.
Why do employers need to fill out this form?
Employers are asked to fill out this form as part of the process to verify employment and income information for individuals applying for state assistance. This verification helps ensure that applicants are eligible for the benefits they are applying for. Additionally, some employers may be eligible for tax refunds or credits for hiring individuals who receive certain state benefits.
How can employers send the completed form back to HHSC?
Once an employer has completed the form, it can be returned to the Texas Health and Human Services Commission via three methods: giving it to the employee to submit, mailing it in the pre-paid envelope provided, or faxing it to the number 877-447-2839.
What should employers do if they cannot answer a question on the form?
If an employer encounters a question on the verification form that does not apply to their situation or the employee in question, they should mark it with "N/A" (not applicable). This indicates that the question does not have a relevant answer in their specific case.
Is there help available for those who have questions while filling out this form?
Yes, assistance is available for individuals or employers who have questions or need help when completing the Employment Verification form. They can call 2-1-1 or 877-541-7905. Additionally, deaf, hard of hearing, or speech-impaired individuals can call 7-1-1 or 800-735-2989 for assistance. All these numbers are free to call.
What information about the employee do employers need to provide?
Employers are required to provide detailed information about the employment status of the individual, including whether they are currently employed or if they were a past employee, the type of job, rate of pay, hours worked per pay period, and other compensations like commissions, bonuses, or overtime pay. Information regarding health insurance, pension plans, and if applicable, the reason for and date of separation, are also requested on the form.
Can employers receive benefits for providing this information?
Employers may be eligible for tax refunds or credits through programs like the Work Opportunity Tax Credit (WOTC) for hiring individuals who receive certain types of state benefits. To learn more about eligibility and how to claim these benefits, employers can visit TexasWorkforce.org/wotc or email the Texas Workforce Commission at wotc@twc.state.tx.us.
When completing the Texas Employment Verification form, it's important to be meticulous to avoid common pitfalls. Here are six mistakes often made:
By avoiding these common errors, the form can be filled out more accurately and effectively, ensuring the intended purpose is served without unnecessary delays.
When completing employment verification in Texas, several other forms and documents are commonly used in conjunction with the Texas Employment Verification form to ensure a comprehensive verification process. These forms and documents not only facilitate a smoother verification process but also ensure compliance with employment and legal standards. Below are five key documents often utilized.
Together, these documents play a vital role in the onboarding process, ensuring that both employer and employee obligations are met. From tax withholding to employment eligibility, and from direct deposit setups to compliance with state-specific requirements, these forms form the foundation of a legally sound employment relationship in Texas.
The Texas Employment Verification form is a vital document for establishing employment status and earnings verifiable by an employer. There are several other documents that share similarities in purpose or content with the Texas Employment Verification form:
Each of these documents, while serving distinct functions, shares the core feature of validating employment status, income, or both, directly contributing to financial, legal, or regulatory processes.
When completing the Texas Employment Verification form, it's vital to pay close attention to the accuracy and completeness of the information. Here are some guidelines that will help ensure the process is done correctly and efficiently:
Completing the Texas Employment Verification form correctly and thoughtfully not only aids in the prompt processing of applications but also supports individuals and families in accessing necessary state benefits. Taking the time to ensure all information is accurate and complete reflects well on the employer and assists employees in their endeavors.
There are several misconceptions about the Texas Employment Verification form that need clarification. Below is a list highlighting and explaining some of the most common misunderstandings.
Addressing these misconceptions ensures both employers and employees handle the Texas Employment Verification form correctly, facilitating smoother process for verifying employment for state benefits or tax credits.
Filling out and using the Texas Employment Verification Form is a straightforward process, yet it's vital for ensuring that both employees and employers adhere to state requirements. Here are key takeaways to keep in mind:
In conclusion, the Texas Employment Verification Form plays a crucial role in the administration of state benefits, making it essential for both employees and employers to understand and properly complete the form. Ensuring accuracy and completeness can help streamline the process for all parties involved.
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