Get Nh Dhhs Dfa 756 2015-2025

This guide provides step-by-step instructions for completing the NH Department of Health and Human Services Division of Family Assistance DFA 756 form online. Designed to assist employers, this form facilitates employment verification for current and terminated employees.

Follow the steps to complete the employment verification form accurately.

1. Click ‘Get Form’ button to access the employment verification form and open it in your preferred viewer.
2. Fill in the eligibility worker name and telephone number at the top of the form. This information helps maintain communication during the verification process.
3. Enter today’s date and the date by which the completed form needs to be returned. This ensures timely processing of employment verification.
4. In the 'FOR CURRENT EMPLOYMENT' section, input the employee's name and social security number (SSN) to identify the individual whose employment is being verified.
5. Provide the date of hire, job title, average hours worked per week, and current rate of pay. Ensure that the rate of pay is accurately formatted to avoid delays.
6. Indicate the employer identification number (EIN) and the date of the first paycheck if this is new employment. This step confirms the legitimacy of the employment.
7. Circle the frequency of pay—weekly, bi-weekly, monthly, or semi-monthly—based on the employee’s payment schedule.
8. List any deductions such as retirement contributions or medical insurance, specifying if they are for the employee's own account or for family coverage.
9. Answer whether there are anticipated changes in the employee’s rate of pay or hours by circling 'Yes' or 'No,' and if 'Yes,' use the back of the form for explanations.
10. For the 'FOR TERMINATED EMPLOYMENT' section, input the employee's name, SSN, date of termination or leave of absence, and specify whether it is permanent or temporary.
11. State the reason for termination and the actual date the final paycheck was received, along with the gross amount of that paycheck.
12. Indicate if the employee received money from other sources and provide details if applicable.
13. Confirm the status of the employee's medical insurance and COBRA availability, including end dates if relevant.
14. Complete the gross wages section for the last four weeks, detailing any additional earnings such as bonuses or commissions, with specific dates of payment.
15. Sign and date the form, including your title and contact information, ensuring the form is submitted correctly.
16. Review the completed form for accuracy, then save changes, download, print, or share the document as necessary.

Complete your NH DHHS DFA 756 form online today for efficient employment verification.