Delaware
Attendant Resources
These forms should be used to facilitate the process as an employee and attendant.
Federal
- Homeland Security Form I-9
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This form is kept in employer files to document that employee is eligible to work in the U.S. It may be presented during a USCIS audit. It requires copies of the identification specified in the accompanying "List of Acceptable Documents."
> Download - IRS Form W-4
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This form should be filled out as part of the attendant application. W-4 indicates the amount of withholding for income taxes. Attendant must indicate number of allowances as well as marital status and sign. Employer's address to be filled in at bottom of W-4.
> Download - W9
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This form should be kept on file by the consumer/employer and documents that the employee is tax exempt. Can be presented at IRS audit.
> Download
JEVS Resource Coordination
- Consumer & Attendant Agreement
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This form should be signed by both the attendant & consumer at the beginning of employment to indicate a formal employer/employee agreement.
> Download - DE PAS Grievance Form
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Either a consumer or an attendant can use this form to report a concern or a complaint about JEVS services to JEVS Human Services' administrative staff.
> Download - Notice of Discontinued Employment
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The consumer and/or attendant complete this form when the employment agreement between the two is broken. It documents the reason for the attendant's discharge or resignation.
> Download - PAS Attendant Application
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This application should be completed and submitted when applying for an open position.
> Download - Personal Attendant Application Checklist
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This is used to verify that all forms in the attendant application have been completed.
> Download
JEVS Payroll
- DE PAS Payroll Schedule
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This form shows the deadlines for submission of timesheets and for payment of attendant for each payroll period.
> Download - DE PAS Timesheet
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This form is signed and verified by both the attendant and consumer and sent to JEVS Human Services' payroll department to report the attendant's biweekly earnings.
> Download Front > Download Back
State Forms
- Adult Abuse Registry Authorization Form
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This form is signed by the attendant and witnessed by another party. As part of the attendant application, this form allows JEVS or a consumer to obtain this state mandated background check on the attendant completing it.
> Download