Pennsylvania
Assistant Resources
These forms should be used to facilitate the process as an employee and assistant.
- Personal Care Assistant Training Guide
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Use this guide to become oriented with the skills necessary to work in the disability field and specifically with consumer/employers in the JEVS' programs.
> Download - PAS Assistant Application
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This application must be completed by the assistant to become an employee.
> Download - PAS Assistant Forms
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This document explains all the forms in the assistant application.
> Download - IRS Form W-4
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This form must be completed and submitted 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 - TeleForm Payroll Schedule
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This form notes timesheet submission deadlines and identifies payment dates over all payroll periods.
> Download - Tele-PAY™ Payroll Schedule
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This form shows the deadlines for consumers and assistants using the Tele-PAY™ system call in/out system and shows payment dates for assistants.
> Download - TeleForm Instructions
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This is an example of how to fill out a TeleForm.
> Download - Tele-PAY Registration Letter
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This form assists the consumer/employer and assistant in the Tele-PAY™ registration process.
> Download - Direct Deposit Enrollment Form
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This is an optional form for assistants who would like their paycheck(s) directly deposited into their bank account.
> Download - Total Pay Card Enrollment Form
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This is an optional form for assistants who would like their paycheck(s) issued onto a Pay Card.
> Download - Total Pay Card FAQs
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This form answers frequently asked questions about the Total Pay Card.
> Download - Notice of Discontinued Employment
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This form should be completed by the consumer and/or attendant upon termination of the employment agreement. Use it to document the reason for the attendant's discharge or resignation.
> Download
