Important Notice: Due to COVID-19, FA is not open to the general public until further notice. Read More

A secure dropbox to the right of our front entrance can be accessed at all hours. Phone calls, emails & faxes encouraged.

Due to COVID-19, FA is now temporarily accepting electronic signatures (from programs such as DocuSign and Adobe Sign) on timesheets. Please use this alternative method only when a signature cannot be obtained in person. Reach out to FA today if you have questions about this policy change.

Employer Agent Forms

Timesheets & Payroll Schedule

Payroll Schedule form

2020 Payroll Schedule

Biweekly Timesheet – Fillable form

Biweekly Timesheet – Fillable

Timesheet Sample

Timesheet Sample

Bi-weekly Timesheet Printable form

Bi-weekly Timesheet Printable

Timesheet Instructions

Timesheet Instructions

Travel Reimbursement Form

Travel Reimbursement Form

New Employee Packet

Use Paperworkr for Your New Hire Packet

Paperworkr lets you auto-fill the information needed onto a PDF. Print and sign each form with ease in less than 10 minutes!

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Care WI form

Employee Packet - Managed Care/Adults

Employee Packet - CLTS

Employee Packet - CLTS/Children

My Choice form

Employee Packet - Private Pay

Employee Packet - CLTS Sauk

Employee Packet - CLTS Sauk

New Employer Packets

Children/CLTS form

Employer Packet - CLTS/Children

Care WI form

Employer Packet -Managed Care/Adults

Children/CLTS form

Employer Packet - Private Pay

Other Employer Forms

Employer/Member Training Resource

Employer/Member Training Resource

Workers' Comp Insurance Info

Workers' Comp Insurance Info

Other Employee Forms

I-9 Form

I-9 Form

Medicaid Provider Agreement for CLTS

Medicaid Provider Agreement for CLTS

Travel Reimbursement Form

Travel Reimbursement Form

I-9 Instructions

I-9 Instructions

Training Verification Form – Managed Care Organizations

Training Verification Form – Managed Care Organizations

W-4 form

W-4 and WT-4 Forms

Medicaid Provider Agreement

Medicaid Provider Agreement - Managed Care Organization

Training Verification Form - CLTS

Training Verification Form - CLTS

New Match Employee Packet

Employee New Match Packet - CLTS

Employee New Match Packet - CLTS/Children

Employee New Match Packet - iCare

Employee New Match Packet - Private Pay

Employee New Match Packet - CLTS Sauk

Employee New Match Packet - CLTS Sauk

Employee New Match Packet - CARE WI

Employee New Match Packet - Managed Care/Adults

New Vendor Forms

Vendor packet

Vendor Packet

W-9 form

W-9

Vendor Check Request

Vendor Check Request

Direct Deposit Authorization

Direct Deposit Authorization

Direct Deposit Authorization

Vendor Check Request (fillable)

Direct Deposit Authorization

2020 Vendor Payment Schedule

Direct Deposit

Direct Deposit Authorization form

Direct Deposit Authorization

WEXrapid! PayCard Fee Schedule

WEXrapid! PayCard Fee Schedule

WEXrapid! PayCard PDF

WEXrapid! PayCard

Surcharge Free ATM Locations PDF

Surcharge Free ATM Locations

Case Managers &
Care Managers

Intake/Referral Form

Intake/Referral Form

Companionship and Live-In Worker Exemptions

Companionship and Live-In Worker Exemptions

Intake/Referral Form

Vendor Intake/Referral Form

Home Care Rule Overview & Flowcharts

Home Care Rule Overview & Flowcharts

Live-in Tax Exemption Notice

Live-in Tax Exemption Notice

Forms in Spanish (Formularios en español)

Intake/Referral Form

Employer Packet /Nuevo Empleador

Companionship and Live-In Worker Exemptions

ACH Direct Deposit/ Autorización de depósito directo

Companionship and Live-In Worker Exemptions

W-4 (2020)

Intake/Referral Form

Employee Packet for CLTS/Información para nuevos empleados - CLTS

Home Care Rule Overview & Flowcharts

WEXrapid! Paycard/ Tarjeta de Nómina rapid!

Home Care Rule Overview & Flowcharts

Payroll Schedule

Live-in Tax Exemption Notice

Employee Packet for MCO/Información para nuevos empleados - MCO

Live-in Tax Exemption Notice

I-9

Get in Touch

We welcome your communication!  If you would like more information about our programs or services, please don’t hesitate to contact us.

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“I just wanted to take a moment and let you know how much I appreciate working with you and your agency. Your assistance with paperwork makes my life so much easier.”

Case Manager of a man with Employer Agent Services

FAQs

Employer Agent Services

Payroll Schedules