DODD Waiver

Employee Forms (Common Law)

  1. New Employee Packet

  2. Checklist

  3. Letter of Introduction

  4. Notice 797

  5. Application for Employment

  6. Employment Tax Information Questionnaire

  7. New Employee Change Notice

  8. Employee Rate Information Form

  9. FSLA Overtime Attestation

  10. Live and Work with the Person You Serve Tax Exemption Form

  11. Direct Deposit Enrollment Form

  12. W-4 Form

  13. IT-4 Form

  14. Employee Eligibility Verification I-9 Form

  15. Medicaid Fraud

  16. Employer Employee Agreement

  17. Medicaid EVV Letter

  18. Sandata EVV Training Registration and Quick Reference

  19. Payroll Schedule 2022

  20. Timesheet/Task Detail

  21. Timesheet/Task Detail Instructions

  22. Transportation Reimbursement

  23. MS OH DODD Consumer-Directed Provider Overtime Records Form

  24. Ohio DODD Program SELF to SELF Travel Timesheet

  25. Appendix A - Service Codes

Employee Forms (Co-Employer)

  1. New Employee Packet

  2. Checklist

  3. Welcome Letter

  4. Instructions

  5. Notice 797

  6. Employment Application

  7. Rate Information Form

  8. Overtime Agreement

  9. Direct Deposit Form

  10. W-4 Form

  11. IT-4 Form

  12. I-9 Form

  13. Medicaid Fraud

  14. Employer Employee Agreement

  15. Live and Work with the Person you Serve Tax Exemption

  16. Medicaid EVV Letter

  17. Sandata EVV Training Registration and Quick Reference

  18. Timesheet/Task Detail Sheet and Instructions

  19. Timesheet/Task Detail Instructions

  20. Transportation Reimbursement

  21. MS OH DODD Consumer-Directed Provider Overtime Records Form

  22. Ohio DODD Program SELF to SELF Travel Timesheet

  23. Appendix A - Service Codes

  24. Payroll Schedule 2022

Employer Forms (Common Law)

  1. Employer Enrollment Packet

  2. Checklist

  3. Letter of Indroduction

  4. Responsibilities and Services

  5. Workers Compensation Guidelines

  6. IRS Form SS-4 Application for Employer Identification Number

  7. IRS Form 2678 Employer Appointment of Agent

  8. Working Agreement

  9. OH JFS 20100 Report to Determine Liability

  10. IRS Form 8821 Tax Information Authorization

  11. OH JFS 20106 Employer’s Representative Authorization

  12. Consent for the Release of Information

  13. Assignment of Consumer and Authorized Representative

  14. OH Dept of Taxation TBOR1 Form

  15. Guide to Employee Forms for the Employer

  16. E-verify Memo

  17. Timesheet/Task Detail Sheet and Instructions

  18. Timesheet/Task Detail Instructions

  19. MS OH DODD Consumer-Directed Overtime Records Form

  20. Ohio DODD Program SELF to SELF Travel Timesheet

  21. Appendix A - Service Codes

Employer Forms (Co-Employer)

  1. Employer Enrollment Packet

  2. Checklist

  3. Letter of Introduction

  4. Responsibilities and Services

  5. Workers Compensation Guidelines

  6. Working Agreement

  7. Consent Release of Information

  8. Web Based Timesheet Enrollment Form

  9. Guide to Employee Forms for the Employer

  10. E-verify Memo

  11. How Much Can I Pay

  12. Timesheet Instructions

  13. Transportation Log

  14. Payroll Schedule

  15. Assignment of Authorized Representative

  16. Timesheet/Task Detail

  17. Timesheet/Task Detail Instructions

  18. MS OH SELF Consumer-Directed Provider Overtime Records Form

  19. Ohio DODD Program SELF to SELF Travel Timesheet

  20. Appendix A - Service Codes

Spending Plan

  1. Waiver Spending Plan (Excel)

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