TX HHS Form H1140. Verification of Benefits

Form H1140, titled Verification of Benefits, is an official document used by the Texas Health and Human Services Commission (HHSC) to confirm information about public assistance benefits received by an individual or household. This form is most commonly used to verify benefits under programs such as Temporary Assistance for Needy Families (TANF) and Food Stamps (SNAP) for specific months.

The form allows HHSC or another authorized agency to request and receive accurate benefit details directly from official records, ensuring that eligibility decisions, reviews, or third-party verifications are based on correct information.

Purpose of Form H1140

The primary purpose of Form H1140 is to authorize the release and verification of benefit information for defined programs and time periods. It is often required when proof of benefits is needed for eligibility determinations, audits, reviews, or coordination with other assistance programs.

This form is not used to apply for benefits. Instead, it confirms benefits that have already been issued or are currently active.

Who Uses This Form

Form H1140 may be completed or requested by:

• Individuals or households receiving TANF or Food Stamp benefits
• Eligibility advisors or caseworkers
• HHSC offices verifying benefit history
• Other agencies that require official benefit confirmation

Explanation of Key Sections

Authorization and Client Information

This section includes the client’s authorization to release benefit information. The client must sign and date the form to allow HHSC to share the requested details for the specified programs and months.

TANF Benefits Information

This section documents TANF benefit data, including the case number, current and prior benefit months, full grant amounts, any penalty amounts, net monthly grant amounts, and household size. It provides a clear picture of benefit history over time.

Food Stamp (SNAP) Benefits Information

This section records Food Stamp benefit details, including the case number, monthly benefit amount, household size, and prior benefit history. It is used to verify both current and past SNAP assistance.

Agency Certification

An agency representative signs and dates the form to confirm that the information provided is accurate and taken from official records.

When Form H1140 Is Required

This form is typically required in situations such as:

• Verifying benefit income for another assistance program
• Confirming benefit history during eligibility reviews
• Providing official proof of TANF or SNAP benefits
• Resolving discrepancies between reported and recorded benefits

If no benefit verification is needed, or if another form of official proof is accepted, Form H1140 may not be required.

Documents Commonly Attached

In most cases, Form H1140 does not require extensive attachments. However, agencies may request:

• Identification documents
• Case numbers or prior correspondence
• Additional verification forms, if applicable

Legal and Regulatory Context

Form H1140 is governed by Texas state law and HHSC administrative rules. The form references provisions of the Texas Government Code that give individuals the right to access, review, and request correction of information collected by HHSC.

The authorization provided through this form ensures that benefit information is released lawfully and only for legitimate administrative purposes.

Practical Tips for Completing the Form

• Specify the exact months for which verification is needed.
• Ensure the client signature and date are completed; unsigned forms are not valid.
• Double-check case numbers to avoid delays.
• Use the most recent version accepted by HHSC.

Common Mistakes to Avoid

• Leaving the authorization section unsigned
• Requesting incorrect benefit months
• Providing incomplete case numbers
• Submitting the form to the wrong HHSC office

Real-Life Examples

• A family applying for housing assistance is asked to provide official proof of SNAP benefits received during the past six months.
• An eligibility advisor needs to confirm TANF benefit amounts during a routine case review.
• A client disputes reported income and requests official verification of prior benefits.

Frequently Asked Questions

Is Form H1140 an application for benefits?

No. It is used only to verify benefits that have already been approved or issued.

Who must sign the form?

The client receiving benefits must sign to authorize the release of information.

Can this form be used for both TANF and Food Stamps?

Yes. The form includes separate sections for both programs.

How long does verification take?

Processing times vary depending on the HHSC office and the requested time period.

Can I request corrections to verified information?

Yes. Texas law allows individuals to request corrections if information is incorrect.

Is this form required for every benefit review?

No. It is required only when official benefit verification is requested.

Micro-FAQ

• Purpose: Verifies TANF and Food Stamp benefits.
• Who files: Benefit recipients with HHSC.
• Programs covered: TANF and SNAP.
• Signature required: Yes.
• Issued by: Texas HHSC.

Related Forms

• Texas TANF Eligibility Forms
• Food Stamp (SNAP) Income Verification Forms
• HHSC Authorization to Release Information Forms

Form Details

• Form Name: Verification of Benefits
• Form Number: H1140
• State: Texas
• Issuing Agency: Texas Health and Human Services Commission
• Revision Date: July 2004