| Brokers - Resources specifically for Support Brokers |
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| 1. |
A - 2010 IFP/Voucher Combo - This fill-in-the-blank Excel file creates the 2010 IFP and vouchers all from one file. Download and save to your computer for each consumer to save time when updating documents. This version includes the address change for St. Coletta as well as the addition of the Waterford Glen AFH to the contracted services page (8-24-2010)
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to download |
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| 2. |
Contracted Services Update - 2010 - This file contains the revised contracted services as of 8-4-2010 and reflects the addition of the Waterford Glenn AFH. This file should be used to update your IFP/Voucher Combo files for each consumer. After updating the contracted services page in your existing IFP/Voucher Combo it will be necessary to RESELECT the first Waisman contracted service in order for the cost to come across correctly to the IFP because the wording of this service has changed.
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to download |
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| 3. |
EER-VOUCHER COMBO - Combo form to be used for Execptional Expense Requests.
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to download |
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| 4. |
Provider Update 8-24-2010 - This file contains the updated provider list as of 8/24//2010, which includes the address change for St. Coletta, and should be used to update your IFP/Voucher Combo files for each consumer as necessary.
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to download |
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| 5. |
Quarterly Report Explanation - Guardians - Explanation of the quarterly financial statements that are mailed to the guardians.
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to download |
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| 6. |
Reports Explained - Explanation of Reports
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to download |
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| 7. |
Required Paperwork for Support Brokers - Explanation of required paperwork
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to download |
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| Rep Payee Documents |
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| 1. |
Brochure - Rep Payee Brochure
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to download |
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| 2. |
Client Budget Summary - Budget form
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to download |
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| 3. |
Client Data Change Form - To be used for any client changes and emailed to FA Rep.
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to download |
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| 4. |
Client Intake Form - To be used for new rep payee clients
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to download |
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| 5. |
Client Intake Form Instructions - Instructions for filling out the Intake Form.
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to download |
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| 6. |
Client Personal Spending Log - To be used for personal spending & petty cash
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to download |
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| 7. |
Client Personal Spending Log Instructions - Instructions on how to fill out the personal spending log
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to download |
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| 8. |
Rep Payee Responsibilities - Chart of responsibilities
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to download |
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| 9. |
Transition Checklist - Checklist of Agency tasks for transition
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to download |
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| 10. |
Transition FAQs - Frequently asked questions for rep payee transition process
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to download |
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| 11. |
Transition Timeline - Timeline overview for rep payee transition
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to download |
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| X - Employer Agent Documents - Documents needed to establish FA as Employer Agent. |
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| 1. |
2010 Payroll Schedule - Payroll deadlines for 2010.
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to download |
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| 2. |
Address Change Form - Use for address changes
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to download |
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| 3. |
Background Information Disclosure - Form & Instructions on obtaining Background Information Disclosure information
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to download |
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| 4. |
Checklist of Support Forms - Support Form Checklist.
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to download |
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| 5. |
Direct Deposit Form for Employer Agent Employees - Use this form if you would like to have your paychecks deposited directly to your bank account. Please make sure to include a voided check when you send the form to Fiscal Assistance.
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to download |
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| 6. |
Employee Change in Status Form - Use to change an employee's status.
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to download |
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| 7. |
Employee Forms Instructions - Instructions for filling out Employee Forms.
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to download |
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| 8. |
Employee or Independent Contractor? - This form should be used to determine if a person is an employee or an Independent Contractor.
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to download |
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| 9. |
Employee Questionnaire - Questionnaire to be used for employees.
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to download |
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| 10. |
Employer Agent Agreement Completion Instructions - Instructions for completing the Employer Agent Agreement
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to download |
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| 11. |
EMPLOYER AGENT INTERACTIVE AGREEMENT - A fill-in-the-blank form that not only does the math FOR you.
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to download |
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| 12. |
Employment Application - Employment Application to be completed by new employees.
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to download |
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| 13. |
Form I-9 - Immigration and Naturalization - Required form to be filled out by employees and employers.
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to download |
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| 14. |
Form W-4 - Federal Withholding Tax - Required form to be filled out by all employees - 2010.
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to download |
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| 15. |
Form W-5 - Earned Income Credit - Earned Income Credit Form - 2010
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to download |
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| 16. |
Form WT-4 - State Tax Withholding - A required form for all employees - 2010
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to download |
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| 17. |
Forms Checklist - Checklist for Employer forms to be completed.
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to download |
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| 18. |
Getting Started in the Employer Agent Program - Information on what is needed to get started using FA as an Employer Agent.
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to download |
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| 19. |
Home Care Consumer Notice - Home Care Consumer Notice
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to download |
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| 20. |
New Employee Docs Packet - All the documents required for a new employee.
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to download |
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| 21. |
Paperwork Tips - Tips on what is needed to use FA as an Employer Agent
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to download |
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| 22. |
Reference Checklist - Checklist to be used when checking employee references.
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to download |
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| 23. |
Resignation Notice - Form to be used when an employee resigns.
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to download |
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| 24. |
Timesheet - Employer Agent - Bi-Weekly Timesheets to be used by employees under the Employer Agent program.
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to download |
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| 25. |
Travel Reimbursement Form - Form to be used for travel reimbursement.
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to download |
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| 26. |
Worker's Comp Insurance Application - Application to be completed to apply for Worker's Compensation Insurance.
click
to download |
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