Effective Date
Instructions
Updated: 10/2025
Purpose
To verify participation in an employment program that meets the criteria for the Supplemental Nutrition Assistance Program (SNAP) 18-54 work requirement.
Procedure
When to Prepare
At application, local workforce staff complete Part I after outreach to verify participation in the Employment and Training (E&T) program for SNAP.
At recertification, Texas Health and Human Services Commission (HHSC) staff provide the form to each non-exempt registrant in the household to verify participation with E&T or another employment program. The household must take the form to the local workforce board for verification and return the completed form to HHSC.
Transmittal
Give one copy to the E&T registrant. E&T staff complete and return the original if the registrant adequately participates. TIERS stores an electronic copy provided to the E&T registrant under Historical Correspondence.
Form Retention
Refer to the Texas Works Manager's Guide for the retention requirement.
Detailed Instructions
Case Name — Enter the name of the head of household’s (HOH’s) name as listed in the case record. The HOH should also be the primary cardholder on the EBT account.
Case No. — Enter the household’s case number.
Date — Enter the date the notice is provided to the SNAP household.
Name of Person — Enter the name of the ABAWD in the household that requires ABAWD E&T Work Requirement Verification.
Part I
If a non-exempt registrant is participating in an E&T program after initial outreach by E&T staff, local workforce staff enter an X in Part I to verify participation.
Part II
If the form is provided to a non-exempt registrant during recertification and taken to the local workforce center, local workforce staff enter an X in Part II to verify current participation in an employment program listed on the form.
Name of Representative — Enter the name of the local workforce staff.
Agency — Enter the name of the local workforce board.
Signature — The local workforce staff signature after completing Part II of the form.
Date — Enter the date the local workforce staff complete Part II of the form.
Area Code and Phone No. — Enter the area code and phone number for the local workforce staff completing the form.
HHSC Address — Enter the HHSC local office closest to the ABAWD’s physical home address.
Area Code and Fax No. — Enter the HHSC fax number that the verification form is sent to.