Form H1136, Child Support Verification

Instructions for Opening a Form

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Effective Date
H1136.pdf (89.3 KB)
H1136-S.pdf (1.71 MB)


Updated: 5/2003


To provide a way for staff to request information from absent parents concerning the support they provide when verification is not otherwise available.


When to Prepare

Use this form to verify child support provided by an absent parent.

Number of Copies

Give or mail the form directly to the absent parent or to the client with an addressed, stamped envelope.


File the completed form on the right side of the case folder with the appropriate application or change form.


See the Texas Works Manager's Guide.


Enter the

  • name and address of the person providing the assistance;
  • date, advisor name, office address, and telephone/fax number;
  • case name and number;
  • name of the person receiving the assistance and the children he/she is receiving the assistance for; and
  • date the form is due.

The absent parent providing support completes the remainder of the form.