Employer Agent Forms
Fiscal Assistance of Dane County, Inc. has assembled the following catalog of downloadable documents and employer agent forms. Please click on the following links to download the corresponding forms.

For Case Managers and Support Brokers (Employer Agent Form)

• Employer Agent Data Form (Excel) - Case Managers and Support Brokers - Please attach a completed FA Employer Agent Data Form to each new employer and new employee application packet.

For In-Home Care Employers

• Complete Employer Application Forms Package (PDF)

For Care Providers - Employees

• Complete Employee Application Forms Package (PDF)

Employee Payment Forms

• 2011 Payroll Schedule (Microsoft Excel)
• Authorization for Direct Deposit (Microsoft Word)