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 - FMS Direct Care Worker Application
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This application must be completed by the direct care worker to become an employee. Watch the Direct Care Worker Application Training Video to help you complete this application.
> Download Application - 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. For help completing your W-4 watch the How to Fill Out Your W4 video.
> Download - 2011 TeleForm Payroll Schedule
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This form notes timesheet submission deadlines and and shows payment dates for direct care workers over each payroll period.
> Download
2012 TeleForm Payroll Schedule
This form identifies the deadlines for timesheet submissions and shows payment dates for direct care workers over each payroll period.
2011 Tele-PAY™ Payroll Schedule
This form shows the beginning and end dates of the pay period for using the Tele-PAY™ call in/out system and shows payment dates for direct care workers. For instructions on how to use the Tele-PAY system watch the TelePay Training Video.
> Download2012 Tele-PAY™ Payroll Schedule
This form shows the deadlines for participants and direct care workers using the Tele-PAY™ call in/out system and shows payment dates for direct care workers. For instructions on how to use the Tele-PAY system watch the TelePay Training Video.
- 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 and Rapid Pay Card Enrollment Form
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Use this form to select or change the way you receive your pay. You can also watch this training video (Pay Selection Video) to help you fill out this form.
> 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
