To provide an alternative means for couples that are common-law married to provide a sworn statement declaring their informal marriage and the date of marriage.
Use to verify the date of a common-law marriage when the couple indicates that they have not filed a Declaration of Informal Marriage with the county clerk's office. Use to determine whether or not to exclude a new common-law spouse's earnings. See A-1369, New TANF Spouse's Earnings, in the Texas Works Handbook.
The client and common-law spouse complete each section and signs the form in Section III.