BFA Form 756 is New Hampshire’s employment verification form: your current or former employer fills it out with your wage and job data, and the New Hampshire Department of Health and Human Services (DHHS) uses that information to decide whether your household qualifies for SNAP, Medicaid, or temporary cash assistance.1New Hampshire Department of Health and Human Services. BFA Form 756 Employment Verification You’ll usually get the form from your assigned DHHS district office, hand it to your employer (or the office mails it directly to the workplace), and the employer completes and returns it by the deadline printed on the form.
Who Fills It Out
The employer fills out BFA Form 756, not you. The form asks for payroll data straight from company records, so an authorized company representative — a payroll manager, HR director, or business owner — enters the information and signs to certify it’s accurate. That signature certifies under penalty of perjury that the figures match the company’s internal payroll records and tax filings.
DHHS needs the verification because state law requires the agency to cross-check income before awarding or continuing public assistance under NH RSA 167:4-c.2New Hampshire General Court. New Hampshire Revised Statutes Section 167:4-c – Income and Identity Verification System The form gives caseworkers a direct snapshot from the employer instead of relying only on what you reported on your application.
What the Employer Needs Before Starting
Pulling records together before starting saves a second round of questions from DHHS and keeps your case moving. The employer should have:
- At least the most recent eight weeks of pay data — gross wages per pay period, hours worked, and the date of each paycheck. Federal Fair Labor Standards Act recordkeeping rules require employers to keep basic payroll records for at least three years, so the numbers should be accessible.
- Company identifiers: Federal Employer Identification Number (EIN), full legal business name, address, and a direct phone number for whoever handles payroll.
- Employment details: start date, pay frequency (weekly, biweekly, semi-monthly), whether the position is full-time, part-time, or per diem, and whether it’s permanent, temporary, or seasonal.3New Hampshire Department of Health and Human Services. SR 23-24 Dated 06/23
- Health insurance information: whether employer-sponsored coverage is available to the employee, and if so, the plan type, policy details, and premium amounts. DHHS uses this to determine whether affordable private coverage is already available before granting public healthcare benefits.3New Hampshire Department of Health and Human Services. SR 23-24 Dated 06/23
- Deduction details: pre-tax deductions such as life insurance and other withholdings, plus whether federal income tax and FICA are withheld.3New Hampshire Department of Health and Human Services. SR 23-24 Dated 06/23
If a raise, cut in hours, or other change to the employee’s pay is scheduled, note it in the additional-information space. Year-to-date figures also help when bonuses or seasonal fluctuations are involved.
Reporting Wages Correctly
Every wage entry should be gross wages — the full amount before taxes and deductions — not take-home pay. The form has columns for pay period dates, hours worked, and gross pay for each check.
Overtime, tips, and commissions each get their own treatment. The form specifically asks whether the employee works overtime and whether all types of tips are accounted for.3New Hampshire Department of Health and Human Services. SR 23-24 Dated 06/23 Separating them from base wages helps the caseworker project ongoing income accurately. A single heavy-overtime paycheck shouldn’t set the baseline for benefits if the standard schedule is smaller.
If the Employee No Longer Works There
For a former employee, the form must show the final date of employment and the reason for separation, along with the final paycheck amount and the date it was issued. Recording the final check prevents DHHS from calculating benefits as if income were still coming in. Health coverage status at the time of separation should also be noted.
Where to Send the Completed Form
The completed form goes back to the DHHS district office handling the applicant’s case, by the “return by” date the caseworker filled in when they sent it out.4Cloudfront.net. State of New Hampshire 756 Missing that deadline can stall an application or interrupt benefits already being paid, so the employer should treat it as time-sensitive.
DHHS operates eleven district offices, and each accepts documents by fax. Common numbers include:
- Concord: (603) 271-6451
- Manchester: (603) 668-5442
- Seacoast: (603) 431-0731
- Keene: (603) 352-2598
- Laconia: (603) 528-4105
- Rochester: (603) 335-5993
A full list of district offices and contact information is on the DHHS website.5New Hampshire Department of Health and Human Services. Locations and Facilities The form can also be mailed to the district office. Applicants who applied online should check whether documents can be uploaded through the NH EASY portal at nheasy.nh.gov.6New Hampshire Department of Health and Human Services. Apply for Assistance There is no fee for submitting the form or for processing a public assistance application in New Hampshire.
What Happens After DHHS Receives It
DHHS uses the employer-reported data, along with other verification sources, to calculate the household’s benefit level. For SNAP, federal rules require an eligibility determination within 30 days of the initial application date.7Food and Nutrition Service. SNAP Application Processing Timeliness That 30-day clock runs from the day the application was filed, not from when verification comes back, so a slow employer response squeezes the time the caseworker has left.
Households in serious financial hardship may qualify for expedited SNAP processing, which shortens the timeline to seven days.7Food and Nutrition Service. SNAP Application Processing Timeliness Expedited processing generally applies when a household has very low liquid assets and monthly income, or when combined income and liquid resources fall below shelter costs. If you think you qualify, tell your caseworker right away, because waiting on the employer’s paperwork can consume the whole seven-day window.
If the wage figures on the form don’t match what you reported, or if something is unclear, a caseworker will call the employer to sort it out. That follow-up is routine. Answering it quickly keeps the case moving and prevents benefits from being suspended while the question is resolved.
If You’re Self-Employed
BFA Form 756 only works when there’s an employer to complete it. Self-employed applicants verify income differently — usually through tax returns, profit-and-loss statements, or a self-employment income statement showing gross receipts and business expenses, backed by receipts, invoices, and bank statements. Ask your DHHS district office which documents your caseworker needs, since the specifics depend on the type of business and how long it has been running.
Privacy and What the Employer Sees
Employers sometimes hesitate to release payroll data, and employees sometimes worry about what their employer will learn. When you applied, you already authorized DHHS to contact your employer, and state law allows the agency to deny or suspend benefits if that authorization is refused.2New Hampshire General Court. New Hampshire Revised Statutes Section 167:4-c – Income and Identity Verification System
The form asks the employer only for employment and wage information. It does not tell the employer which specific benefit you applied for or reveal anything about your household finances. Medical information protected under the ADA or FMLA stays confidential and does not belong on the form; any health-related entries should be limited to the insurance availability and premium fields the form actually asks about.