Florida’s Verification of Employment/Loss of Income form, CF-ES 2620, is filled out by your employer, not by you. You hand it to your current or former employer, they complete the sections the Department of Children and Families has checked off, sign it, and you return it to the caseworker handling your SNAP, Temporary Cash Assistance, or Medicaid application.
Where to Get the Form
In most cases the caseworker gives you a copy with the relevant sections already marked. If you need to download it yourself, it’s available through the DCF forms portal at eds.myflfamilies.com and is also hosted on FloridaCommerce’s website, floridajobs.org (formerly the Department of Economic Opportunity).1Florida Department of Economic Opportunity. Verification of Employment/Loss of Income Form CF-ES 2620 Use the version the agency directed you to, since some offices occasionally use their own variations.
Who Fills It Out
A common misunderstanding is that the applicant fills out most of this form. You don’t. The CF-ES 2620 is designed for your employer to complete, and there is no applicant signature line anywhere on it. Your signature belongs on your benefit application, not on this verification.
Your role is to deliver the form to your employer, make sure they complete the sections the agency marked on page one, and return the signed form to the agency. The agency only wants answers to what it checked off, so your employer doesn’t need to fill in the whole document.
What Each Section Asks
Section I: General Information
This is the longest part. The top asks for your full name, Social Security number, and address. Providing the SSN speeds up identity verification and eligibility checks; declining may delay processing.
Your employer then fills in the employment details: job title and type of work, hours and days worked per week, pay frequency (daily, weekly, biweekly, or monthly), rate of pay, the date your current employment began, and dates of any earlier stints with the same employer. They also indicate whether you receive tips, whether the job is seasonal (with start and end dates), your health insurance coverage and dependents on the plan, any payroll savings or profit-sharing balance, and whether you work from your own home, the employer’s location, or somewhere else.1Florida Department of Economic Opportunity. Verification of Employment/Loss of Income Form CF-ES 2620 Fields that don’t apply should be marked “N/A” rather than left blank without explanation.
Section II: Loss of Income
This section applies only if you’ve lost your job or had your hours reduced. The agency will check the box if it’s relevant. Your employer records the date employment ended, the reason (layoff, resignation, end of contract, and so on), whether the loss is permanent or temporary, and if temporary, when they expect you back. They also list the date and gross amount of your final paycheck, any remaining payouts such as vacation pay or retirement refunds, and whether you’re eligible for extended benefits like COBRA or workers’ compensation.2Florida Department of Economic Opportunity. Verification of Employment/Loss of Income Form CF-ES 2620 – Section: Loss of Income The permanent-versus-temporary distinction matters because it affects the type and duration of benefits you may qualify for.
Section III: Record of Pay Received
Section III is a table listing gross pay for your last four weeks of employment. For each pay period, your employer enters the period ending date, the date you received the check, gross earnings, regular hours worked, rate of pay, overtime hours and rate, tip income, and any Earned Income Credit paid through your check. If your hours or rate changed during those four weeks, the employer is asked to explain why. Gross amounts, before taxes and deductions, are what the agency wants.1Florida Department of Economic Opportunity. Verification of Employment/Loss of Income Form CF-ES 2620
Section IV: Employer Signature
The last section collects the employer’s signature, job title, business name, phone number, address, and the date. Above the signature line is a fraud warning: the employer acknowledges the information is true to the best of their knowledge and that intentionally false information may result in prosecution.1Florida Department of Economic Opportunity. Verification of Employment/Loss of Income Form CF-ES 2620
If Your Employer Won’t Complete the Form
Sometimes a former employer has closed, can’t be reached, or refuses. Your application doesn’t have to stall. DCF accepts alternative income documentation, including pay stubs, payroll checks, wage statements, and written letters from employers or other income sources.3Florida Department of Children and Families. Calculation of Benefits
If you’re self-employed, the usual approach is to estimate current income from your most recent tax return and any business records you keep. The agency has several methods for calculating self-employment income, including projecting from the prior year’s profit.3Florida Department of Children and Families. Calculation of Benefits
Contact your caseworker as soon as you realize your employer won’t cooperate. Flagging it early lets the agency work with your alternative documents instead of holding up your case.
Submitting the Form and Processing Times
Once your employer has completed and signed the CF-ES 2620, return it to the agency that requested it. You can mail it, upload it through the agency’s online portal, or drop it off at a local DCF office. Make a copy for your records before you submit. If you mail it, use a method with delivery confirmation.
Federal rules set the deadlines on the agency’s side. For SNAP, eligible households must receive benefits within 30 days of filing the initial application. Households that qualify for expedited service, generally those with very low income and minimal liquid assets, must have benefits on their EBT card no later than the seventh calendar day after filing.4eCFR. 7 CFR 273.2 Office Operations and Application Processing Those clocks run on the application as a whole, not on any single form, but a missing or incomplete CF-ES 2620 is one of the most common reasons applications slip past those windows.
Penalties for False Information
The fraud warning above the employer’s signature is not decorative. Under Florida law, knowingly providing false information on a public assistance application, or failing to disclose a material fact such as additional income or a change in employment, is a criminal offense. The charge scales with the amount wrongfully obtained:
- Under $200 in a 12-month period: first-degree misdemeanor
- $200 to under $20,000: third-degree felony
- $20,000 to under $100,000: second-degree felony
- $100,000 or more: first-degree felony
The penalties reach anyone involved, including someone who aids another person in misrepresenting their situation.5Florida Senate. Florida Statutes 414.39 – Fraud An employer who deliberately understates your wages on the form can face prosecution too. On top of criminal charges, the agency will seek repayment of any benefits you weren’t entitled to, and for SNAP, a first offense carries a 12-month disqualification, a second offense 24 months, and a third permanent disqualification.