All Other Program Forms

Forms that simplify your journey to independence

In self-direction, both Participants and Direct Care Workers are required to complete a series of forms with their financial management services provider. PAS is here to support you in completing the proper requirements.

Participant Packet - Complete

Enrollment Checklist

Onboarding Form

IRS Form SS4 - Application for Employer Identification Number

Sample SS-4 Completed Form

IRS Form 2678 - Employer/Payer Appointment of Agent

Sample 2678 Completed Form

IRS Signature Requirements

Michigan UIA 1488 - Power of Attorney

Release of Confidential Information Authorization

Authorized Representative Form

Backup Supports

Household Employer Orientation

Referral Form

Ageways Enrollment Packet

Ageways VA Enrollment Packet

CLS Wayne / DWIHN Enrollment Packet

DAAA Enrollment Packet

Molina Enrollment Packet

MORC Enrollment Packet

R2 Enrollment Packet

Region 7 Enrollment Packet

St. Clair Enrollment Packet

TIC Enrollment Packet

TSA Enrollment Packet

Valley Enrollment Packet

Rate Change Form

Live-In Exemption Form

Wisely Paycard Overview

Sample I-9 Completed Form

IRS Signature Requirements

Address Change Request Notification

2025 - 2026 Payroll Schedule

Earned Sick Time Act - Timesheet

Rate Change Form

Wisely Paycard Overview

PAS Employer Pay Authorization (EPA)

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PAS Attendance Incident Report (AIR)

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PAS Progress/Visit Note (PVN)

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DoscuSign Instructions

If you have questions about the forms on this page or other aspects of self-direction, please contact PAS today.

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