TAP VDHCBS Forms

Employee Forms

  1. New Employee Packet
  2. Cover Page
  3. New Employee Change Notice
  4. W-4 Employee Withholding Certificate
  5. Utah Tax Information Questionnaire
  6. Notice 797
  7. I-9 Employee Eligibility Verification
  8. Direct Deposit
  9. Provider Code of Conduct
  10. Timesheet

Employer Forms

  1. UT – TAP VDHCBS Waiver Packet
  2. Cover Page
  3. Welcome Letter
  4. Packet Instructions
  5. SS-4 Application for Employer Identification Number
  6. Form 2678 Employer-Payer Appointment of Agent
  7. 8221 Tax Information Authorization
  8. Domestic Employment Status Report
  9. Work Agreement
  10. Everify Memo of Understanding UT
  11. Online Expense Summary Enrollment
  12. Employment Application
  13. UT Consent for the Release of Information
  14. Payroll Schedule
  15. Timesheet

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