Get Contractor Reporting Form - Iowa Department Of Human Services - Secureapp Dhs State Ia

The Contractor Reporting Form is an essential document for individuals and organizations providing contracted services to the Iowa Department of Human Services. This guide will help you complete the form online efficiently and accurately.

Follow the steps to successfully fill out the Contractor Reporting Form.

1. Click ‘Get Form’ button to obtain the form and open it in your document editor.
2. Fill in the 'Payor of Income' section. Provide the payor's telephone number, ensuring to include the area code. Next, enter the Federal ID Number (FEIN) with the corresponding three-digit Iowa location suffix.
3. Complete the 'Contractor' section by providing the contractor's date of birth. Fill in the contractor's last name, middle initial, and first name. Ensure you include the street address, city, state, and ZIP code in this section.
4. Next, specify the date of contracted service by entering the month, day, and year. Double-check the entries to ensure accuracy.
5. Review the reporting requirements at the bottom of the form. Ensure you are aware of the need to mail the completed form within 15 days of signing the contract. The mailing address should read: Centralized Employee Registry, PO Box 10322, Des Moines IA 50306-0322.
6. Once all sections are complete, save your changes. You can also choose to download or print the form for your records or to share via mail as indicated.

Complete your Contractor Reporting Form online today for a seamless submission experience.