Get Payment Request Form - Takecharge

This guide provides a clear and comprehensive overview of how to fill out the Payment Request Form - TakeCharge online. Follow these steps to ensure that you accurately complete the form and submit it for processing.

Follow the steps to successfully complete your Payment Request Form.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Enter the beneficiary’s name and Social Security number in the designated fields. Ensure that this information is accurate to avoid delays in processing.
3. Fill in the employer's name and address. This section is vital as it links your employment to your payment request.
4. Specify the address where you would like your Work Support Payment(s) to be mailed. If this is a new address, clearly write 'NEW ADDRESS!' at the top of the form to update your records.
5. Provide your phone number for any follow-up questions or clarifications from the processing team.
6. Indicate whether you are currently receiving benefit checks from Social Security and specify if you receive SSI, SSDI, or both.
7. List the calendar month(s) for which you are claiming that your earned income exceeded the Substantial Gainful Activity (SGA) level, noting you cannot list months where you received Social Security benefits.
8. In the certification section, sign and date the form to confirm that the information provided is accurate to the best of your knowledge.
9. Keep in mind that you need to attach photocopies of your pay slips for the months you listed to provide evidence of your earnings.
10. Finally, submit your form by mailing it to the address provided for TakeCharge Processing and consider reaching out to customer support for any queries.

Start filling out your Payment Request Form - TakeCharge online today for a smoother payment process!