TX HHS Form 3059. CSHCN Employment Verification

The TX HHS Form 3059, CSHCN Employment Verification, is a crucial document used to verify employment information for Children with Special Health Care Needs (CSHCN) services program. This form helps employers provide accurate and timely information about their employees' work status, which is essential for ensuring that eligible individuals receive necessary support and benefits.

This form requires employers to provide detailed information about the employee, including name, address, job type, pay rate, and average hours per pay period. Employers must also list all wages received by the employee during a specific month or period, along with any tips, commissions, or bonuses. Additionally, employers are asked to indicate the date of separation and reason for termination if the employee is no longer employed.

The TX HHS Form 3059 should be used when an employer needs to verify employment information for an individual who receives CSHCN services. This form is particularly important in situations where employees have special health care needs or are receiving benefits related to their work status. By completing this form, employers can help ensure that eligible individuals receive the necessary support and benefits, while also maintaining accurate records of employee employment history.