TX HHS Form 3049. Employment Verification

The TX HHS Form 3049, Employment Verification, is a crucial document used to determine eligibility for healthcare assistance programs. This form helps employers verify the employment status of an individual applying for health care benefits from the Primary Health Care Services Program, Title V Fee-for-Service Program, and/or epilepsy benefits.

This form requires employers to provide specific information about their employee's employment status, including whether they are/were/will be employed by them. Employers must also indicate if FICA or FIT is withheld. The form should be completed accurately and thoroughly, as the provided information is necessary for determining the household's eligibility.

The TX HHS Form 3049, Employment Verification, should be used when an individual applies for healthcare assistance programs and their employer needs to verify their employment status. This form must be completed not later than a specified date and can be submitted by mail or fax. The Texas Health and Human Services (HHS) provides this form as a tool for employers to assist in the verification process.