TX HHS Form H1028-A. Employment Verification (Aged and Disabled Programs)

The Employment Verification Form H1028-A is used to determine the eligibility of individuals applying for assistance from the Texas Health and Human Services Commission or whose income affects another household member's application. This form helps verify all earnings necessary for determining household eligibility.

To complete this form, employers are required to provide information about their employees, including name and address, social security number, job type, rate of pay, and health insurance availability. Employers must also indicate whether the employee is or was employed by them, and if so, what type of job they held. Additionally, employers may need to provide details on overtime pay, FICA or FIT withholding, and profit sharing or pension plans.

This form is typically filled out by employers who have had employees apply for assistance from the Texas Health and Human Services Commission or whose income affects another household member's application. The completed form must be returned to the commission by a specified date. Key points to remember include ensuring all information is complete and correct, as it will affect someone's eligibility and benefits.

• This form is used for employment verification purposes only.
• Employers are required to provide specific information about their employees.
• The completed form must be returned to the Texas Health and Human Services Commission by a specified date.