Form H2581, Choices Noncooperation Report

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Effective Date: 11/2016


Updated: 11/2016


To provide a two-way communication form between Choices staff and Texas Works staff to:

  • notify Texas Works staff of Choices need for Choices penalty/sanction,
  • notify Texas Works staff of Choices need for parenting skills penalty, and
  • provide a means for Texas Works staff to respond to a request for noncompliance penalty/sanction.


When to Prepare

Choices staff complete Form H2581 to request Texas Works staff to penalize/sanction a Choices client who is nonexempt and who fails to participate.

Texas Works staff complete Form H2581 in response to a request for noncompliance penalty/sanction.

Number of Copies

Prepare an original and two copies.


Choices staff send the original and first copy to Texas Works staff and retain the second copy in the case record.

Texas Works staff make a response, return the original to Choices staff, and retain the first copy (Texas Works staff may instead originate a new Form H2581, if desired).

Texas Works staff file the first copy under work registration.

Form Retention

Choices Staff — Keep Form H2581 in the case record for three years after the case is closed.

Texas Works Staff — See Texas Works Manager's Guide.


To — Self-explanatory.

From — Self-explanatory.

Choices staff enter the following:

Client Name — Enter the client's complete address.

For Temporary Assistance for Needy Families (TANF)-UP cases, enter other parent's name and client number. Indicate whether participating in Choices.

Case Name — Enter the name of the TANF case in which the client is included. If the case name is the same as the client name, enter "same."

Case Number — Enter the TANF case number from the Form H1000-B or Choices System.

Eligibility Determination Group (EDG) No. — Enter the EDG number.

Part I — Message from Choices Staff to Texas Works Staff:

Check the appropriate box if requesting Texas Works staff to apply penalties/sanctions against client. For failure to participate failure to respond to outreach, or demonstrated cooperation. Penalties/sanctions are applicable only for clients who are nonexempt but do not participate and do not have good cause. Check the box to indicate whether the penalty/sanction is requested because the attempt to conciliate was unsuccessful or if the client failed to respond to outreach. Indicate the date the decision to refer for penalty/sanction was made. This date must correspond with the date entered on the Choices system. Note: Do not request penalties/sanctions on clients in minimum service counties.

Comments — Enter comments, if any.

Signature — Choices staff sign and date the form.

Part II — Response from Texas Works Staff to Choices Staff:

Complete this part of Form H2581 as instructed in the Texas Works Handbook A-1845.1 and

Comments — Enter comments, if any.

Signature — Texas Works staff sign and date the form.