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Effective Date: 



Updated: 10/2017


To provide a two-way communication form between eligibility staff and employment contractor staff administering SNAP employment services.


When to Prepare

The employment contractor staff send eligibility staff Form H1816 to:

  • report to eligibility staff a client's noncompliance; and
  • provide to eligibility staff the contractor's recommendation on a client's claim of good cause for noncompliance.

Staff sends the employment contractor Form H1816 to report that:

  • a client has served his penalty period and agrees to comply with employment and training requirements; and
  • during the adverse action notice period a client wishes to claim good cause for not complying with an employment/training requirement.

After the client has agreed to comply, if the client requests, eligibility staff may provide Form H1816 to the client to take to the Texas Workforce Commission.

Number of Copies

The originator completes an original and two copies of Form H1816.


The originator sends the original and copy one to the respondent, and retains copy two. If a response is needed, the respondent makes his response, returns the original to the originator, and retains copy one (the respondent may initiate a new Form H1816 instead, if desired.)

Form Retention

See the Texas Works Manager's Guide for the retention requirement.

Detailed Instructions

To: (Eligibility Staff) — Enter Texas Works Staff receiving the form, if known.

Eligibility Staff Address: —— Enter address of eligibility staff receiving the form, if known.

From: (Employment Contractor) — Enter originator's name and address.

Employment contractor enters the following:

Client's Name — Name of the individual

Client No. — Enter the client number.

Case Name — Enter the name of the head of household for the case in which the client is included. If the case name is the same as the client’s name, enter "same."


Completed by TWC Staff

Check the appropriate box for the reason for the sanctions.

  • Check the appropriate box for the reason for the sanction.
  • If the client reports good cause, check the box for, We explored good cause with the client. Good cause recommended.
  • Enter the Date of good cause claim.

Comments — Enter a description of the good cause reason the client reported.


Completed by HHSC Eligibility Staff

Check the appropriate box to report whether the client has served their penalty or has reported good cause.  Enter the reported date if the client reported good cause.

Enter comments, if needed.

Sign and date the form.