Forms
Enrollment Packets
Enrollment Resources
Form Samples
Timesheet and Payroll Related Forms
- Timesheet (PDF - 450 KB)
- Timesheet Instructions (PDF - 246 KB)
- 2019 Payroll Calendar - Schedule A (PDF - 121 KB)
- 2019 Payroll Calendar - Schedule B (PDF - 121 KB)
- Federal W-4 (PDF - 57 KB)
- Virginia VA-4 (PDF - 79 KB)
- Difficulty of Care Exemption - Compliance with IRS Notice 2014-7 (PDF - 101 KB)
- Live-In Exemption Form (PDF - 134 KB)
- Authorized Representative Agreement and Signatory Authority (PDF - 120 KB)
- Authorized Representative Agreement and Signatory Authority - Spanish (PDF - 120 KB)
- Pay Selection Form (PDF - 164 KB)
- Pay Selection Form - Spanish (PDF - 150 KB)
Service Facilitator
Trainings
Other
- Attendant Contact Information Change Form (PDF - 103 KB)
- Consumer Contact Information Change Form (PDF - 103 KB)
- Employer of Record Contact Information Change Form (PDF - 91 KB)
- Feedback Form (PDF - 93 KB)
- I-9 Instructions (PDF - 565 KB)
- Notice of Discontinued Employment (PDF - 95 KB)
- Pay Card Instructions (PDF - 259 KB)
- Secure Email Instructions (PDF - 595 KB)
Transition Packets
- Attendant Transition Packet (PDF - 1.70 MB)
- Attendant Transition Packet - Spanish (PDF - 1.33 MB)
- Attendant Transition Packet Form Samples (PDF - 777 KB)
- Employer Transition Packet (PDF - 3.73 MB)
- Employer Transition Packet - Spanish (PDF - 3.57 MB)
- Employer Transition Packet Form Samples (PDF - 1.05 MB)