Minnesota Form DHS-2146 is the “Authorization for Release of Employment Information” — the release you sign so your county or tribal human services office can get wage and job details straight from your employer. You complete the identifying information and sign it, your employer fills in the payroll section, and the completed form goes back to the agency handling your case. Counties use it to verify income for Medical Assistance, the Minnesota Family Investment Program (MFIP), SNAP, and other public assistance programs.
When You’ll Be Asked to Use It
County and tribal agencies request DHS-2146 to confirm employment when you apply for benefits, renew them, or report a change in your job. Any employment start, stop, or wage change can trigger the request.1Anoka County, MN. Forms For SNAP, the agency verifies employment at application and whenever your wages change or a job ends, including any job that ended within 60 days of your application.2Minnesota Department of Human Services. Mandatory Verifications – SNAP
You often don’t need DHS-2146 at all. If you can hand over recent pay stubs that show your gross pay, hours, and pay dates, that’s usually enough on its own.3Minnesota Department of Human Services. MA-EPD Mandatory Verifications Ask your caseworker before starting the DHS-2146 process. Note also that if the agency needs to know whether your employer offers health insurance — for MinnesotaCare, for example — that information is collected on a different form, DHS-3348, not on DHS-2146.4Minnesota Department of Human Services. Verification of ESI – MinnesotaCare Access to ESI
Where to Get the Current Form
Download DHS-2146 from the Minnesota DHS searchable document library (eDocs). Go to the eDocs page, type “DHS-2146” in the search field, and open the PDF.5Minnesota Department of Human Services. Searchable Document Library (eDocs) DHS recommends opening the file in Adobe Reader or Adobe Acrobat rather than in your browser, because some browser PDF viewers scramble form fields. Your county human services office can also mail or hand you a printed copy on request.
Filling Out Your Section
Your part of the form is short. You provide your name, Social Security number (or the last four digits), and your employer’s name, then sign the authorization. Your signature does two things at once: it tells the agency it may contact your employer, and it tells your employer it may release your employment records to the agency. Without that signature, the employer has no authorization to send anything back.
What Your Employer Fills In
The employer’s portion carries the numbers the caseworker actually uses to calculate benefits:
- Hire date and current employment status, and if applicable, the date and reason employment ended.
- Gross pay — your earnings before taxes and voluntary deductions — broken out by pay period.
- Hours worked in each pay period, which matters for programs that tie eligibility to work participation.
- Pay frequency (weekly, biweekly, or other) and the specific dates of recent paychecks.
Employers generally pull this from formal payroll records covering your most recent pay periods. Payroll data straight from the system is less likely to conflict with what the employer already has on file, and a discrepancy can hold up your case.
The 15-Day Deadline
Once the agency requests verification, you generally have 15 days to return the completed form. If the last day falls on a weekend or legal holiday, the deadline moves to the next business day. During an initial application, missing the 15-day window doesn’t automatically sink you: as long as your application is still within its processing period, the agency can use a late verification to finish your case. At renewal, if your case has already closed, you have until the end of a 30-day reinstatement period to get verifications in.6Minnesota Department of Human Services. Verification Due Dates
The bottleneck is almost always the employer, not you. Hand-delivering the form to your payroll or HR contact and pointing out the deadline in person works better than mailing it and waiting. Follow up a few days later if you haven’t seen it come back.
Submitting the Completed Form
Once your employer’s section is filled in, send the form to the county or tribal agency handling your case. Most counties accept it several ways:
- By mail, to the address on your verification request letter.
- By fax, to the secure number listed on your request letter or on the county office’s website.
- Online, through the MNbenefits document upload tool; a separate upload tool handles Medical Assistance renewals.7Minnesota Department of Human Services. Ready to Upload Documents8Minnesota Department of Human Services. Upload Documents
- In person, at your county human services office.
If you upload online, include your case number. Without it, the agency may struggle to match your document to your file, which causes delays.8Minnesota Department of Human Services. Upload Documents
What Happens After You Turn It In
A caseworker compares the payroll data on the form against what you reported on your application or renewal. If everything matches, the worker updates your case file and your benefits continue as they were. If the employer’s numbers differ from yours — for instance, if your reported income was lower than what the employer documented — the worker adjusts your benefit amount to match the verified figure.
The agency then mails you a notice of action. That notice must state the action taken, which household members are affected, the effective date of the change, the reason, and your right to appeal. If your benefits are being reduced or coverage ended, you generally get 10 days of advance notice before the change takes effect. In cases involving probable fraud where the facts have been verified, that advance notice can be shortened to five days.9Minnesota Department of Human Services. Notices – Eligibility Policy Manual
If the verified income leads to a reduction or termination you believe is wrong, you can appeal in writing by mail, fax, or in person at a DHS office. SNAP appeals can also be filed by phone, and the state accepts online appeals through Form DHS-0033.10Minnesota Department of Human Services. Appeals
Getting the Numbers Right
Providing false or misleading information on employment verification can lead to an intentional program violation (IPV) finding through an administrative disqualification hearing. An IPV covers willfully making a false statement, concealing facts, or misrepresenting your situation, and the standard of proof is “clear and convincing” evidence.11Minnesota Department of Human Services. Administrative Disqualification Hearings (Archive) A first offense brings a 12-month disqualification from the program, a second offense 24 months, and a third offense permanent disqualification. A person convicted in state or federal court of making fraudulent residency statements to collect duplicate benefits from multiple states faces a 10-year disqualification.12Minnesota Department of Human Services. Disqualification for Fraud Criminal prosecution is also possible, though the agency will not pursue both an administrative hearing and criminal charges for the same violation at the same time.
The practical takeaway: report what you actually earn, and let the employer’s payroll figures speak for themselves. If your own estimate and the employer’s numbers turn out to differ, the caseworker will use the verified figure and adjust from there.