Delaware
Attendant Resources
These forms should be used to facilitate the process as an employee and attendant.
Federal
- Form I-9
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This form is used to document that an employer is eligible to work in the United States.
> Download - Form W-4
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Form W-4 indicates the amount of income tax allowance that an attendant chooses.
> Download - Form W-9
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To be kept on file for attendants exempt from FICA taxes.
> Download
JEVS Resource Coordination
- Agreement Between Consumer and Attendant
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This is signed by both the attendant and the consumer at the beginning of employment to indicate a formal employer/employee agreement.
> Download - Authorization for Release of Worker's Compensation Information
- This form allows the insurance carrier to share limited information about the policy with JEVS staff.
> Download - Grievance Form
- To report a concern or a complaint about JEVS' services to our administrative staff.
> Download
- Notice of Discontinued Employment
- The consumer or attendant completes this form when the employment agreement between the two is broken.
> Download - PAS Attendant Application
- Submit before hiring a new attendant.
> Download
- Personal Attendant Application Checklist
- Used to check that all forms in the attendant application have been completed.
> Download
JEVS Payroll
- Payroll Schedule
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Shows the deadlines for submission of timesheets and for payment of attendant for each payroll period.
> Download - Timesheet
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Sent to JEVS Payroll Department to report the attendant's biweekly earnings.
> Download Front > Download Back
State Forms
- Adult Abuse Registry Authorization
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Allows JEVS or a consumer to obtain this background check on the attendant completing it.
> Download