Get Ms Mdhs-ea-910 2018-2025

Filling out the MS MDHS-EA-910 form is an essential step for requesting employment verification for individuals receiving public assistance in Mississippi. This guide will walk you through the process of completing the form online, ensuring that you provide all the necessary information accurately.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the employment verification request document and open it in the editor.
2. Begin by filling in the case name and TANF/SNAP case number at the top of the form.
3. Input the details of the employer or company from which you are requesting information, including 'To:', 'From:', 'Fax/Email:', and 'Phone:' fields.
4. Enter the employee's name, signature, and date in the designated areas to authorize the release of wage information.
5. Provide the employee's Social Security Number (SSN) in the specified field.
6. The MDHS worker will need to add their signature and date in the appropriate section.
7. Indicate whether the individual is a current or former employee by checking the corresponding box.
8. For current employees, fill in additional details like the date hired, start date, type of job, hourly wage, hours per week, scheduled overtime hours, and pay frequency.
9. For former employees, enter the date employment ended, date of final check, gross amount of the check, and the reason for employment ending or leave taken.
10. Complete the wage information section for current or past pay periods by filling in dates, actual hours worked, gross pay, and any other pay, such as tips or bonuses.
11. Finish by signing and filling in your name, title, business name, address, date, city, phone, and fax number at the bottom of the form.
12. Finally, review your entries for accuracy, then save your changes, download the completed form, print it, or share it as needed.

Complete your MS MDHS-EA-910 form online today to facilitate the employment verification process.