Achieve With Us.

  • About
    • Latest News & Headlines
    • General Information
    • Mission Statement
    • Our History
    • Annual Report & Financial Information
    • Newsletter
    • Staff
    • Board of Directors
    • Press
  • Services
    • Legal Advocacy
    • Governmental & Financial Benefits
    • Special Education Law
    • Community & Information Outreach Referrals
    • Etheridge Plan
    • Dignified Lifestyles
  • Fiscal Intermediary
    • General Information & Announcements
    • Pay Period Schedule
    • Forms
  • Events & Fundraising
    • Dove Awards
    • Michigan Performing Arts Talent Show
    • Tom’s Marathon Challenge
    • Holiday Annual Giving
    • Sponsored Activities
  • Resources
    • Attorney List
    • Income Tax Guide
    • Residential Options
    • SSI Rates
    • MI Choice Waiver Program
    • Additional Links
  • Membership
  • Contact

Forms

Home » Fiscal Intermediary » Forms

Employer of Record Forms:

All forms listed below are required in order to participate in the Employee of Record program:

Background Check Release Form (PDF)

Child Waiver Employment Agreement (PDF)

DHS Clearance Form (to be filled out by employees who provide services for consumers under the age of 18 only) (PDF)

Direct Deposit (PDF)

Employer of Record Agreement (PDF)

Fiscal Intermediary authorized signatures (PDF)

Form W-4 (PDF)

Michigan W-4 (PDF)

W-9 (PDF)

W-9 Instructions (PDF)

Additional Forms:

2011 Payroll Pay Period Schedule (PDF)

Child Waiver Program Voucher (PDF)

CLS/EOR Time Sheet (PDF)

Employer of Record Fax Cover Sheet (PDF)

Mileage Log (PDF)

MORC Community Living Supports Log (PDF)

Respite Only Forms:

All forms listed below are required in order to participate in the Respite Only program:

Affidavit (PDF)

Background Check Release Form (PDF)

DHS Clearance Form (to be filled out by employees who provide services for consumers under the age of 18 only) (PDF)

Direct Deposit (PDF)

Respite Invoice (PDF)

Respite Provider Agreement (PDF)

W-9 (PDF)


Latest News & Headlines

  • Local Fun For Everyone Open House 2/29/12
  • Recreational Opportunities Open House
  • 2012 Dove Awards Nomination Form
  • Medicare & Medicaid Dual Eligibility Forum 11/10/11
  • Getting My Own Address for People with ASD and Developmental Disabilities Guide

Contact Us

Stay Connected with The Arc of Oakland County

Follow Us on FacebookFollow Us on PicasaFollow Us on YouTubeFollow Us on RSS

The Arc of Oakland County | 1641 West Big Beaver Road | Troy, MI 48084 | Phone: 248.816.1900 | Fax: 248.816.1906 | Email: info@thearcoakland.org

© 2012 The Arc of Oakland County MI