Aging Waiver

Employee Forms

  1. UT – Aging Waiver Packet
  2. Cover Page
  3. New Employee Change Notice
  4. W-4 Employee’s Withholding Certificate
  5. Live and Work with the Person you Serve
  6. Utah Tax Information Questionnaire
  7. Notice 797
  8. Direct Deposit
  9. Provider Code of Conduct
  10. I-9 Employment Eligibility Verification
  11. Timesheet

Employer Forms

  1. UT- Aging 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. 8821 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. EVV Data Information Form
  15. How Much Can I Pay
  16. Payroll Schedule
  17. Timesheet

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