Bar Code Area
Central File Maintenance
P.O. BOX 12048
AUSTIN, TX 78711-2048
Employee DOB (MM/DD/YY):
VERIFICATION OF EMPLOYMENT
Dear Employer :
The Office of the Attorney General is attempting to locate the above-named person. We have received information that this
person is currently working for you or has worked for you in the past. State law requires you to provide the information
requested below. [Texas Family Code Chapter 231.302] We will keep this information confidential and will use it only for
the purpose of collecting child support.
IF this person is NO LONGER EMPLOYED by your company,
COMPLETE ONLY THE INFORMATION IN THE BOX on the other side.
IF this person is STILL EMPLOYED by your company,
PLEASE PROVIDE THE INFORMATION IN THE BOX AND ALL APPLICABLE INFORMATION BELOW THE BOX.
Please use the enclosed postage-paid envelope to return the form to our office. If you prefer, you may complete the form
online by visiting our website at
I certify that the information requested for this individual is required for the performance of this agency’s official duties.
Thank you for your assistance.
Office of the Attorney General of Texas
Title IV-D Agency
EMPLOYER ADDRESS AND CONTACT INFORMATION
Please review your address above. Unless other information is provided by you, future correspondence from the Child
Support Division (including child support orders and writs) will be sent to this address.
Is the above address correct for future correspondence?
If no, please provide correct address:
(see other side)