Get Dcw Fillable Application Packet

Completing the Dcw Fillable Application Packet online is a straightforward process designed to gather essential information for your employment as a direct care worker. This guide will help you navigate each section of the form to ensure you submit a complete and accurate application.

Follow the steps to successfully complete the application form online.

1. Press the ‘Get Form’ button to access the Dcw Fillable Application Packet and open it for editing.
2. Select the type of application you are submitting by checking the appropriate box for either 'New DCW' or 'Existing DCW'. If you are an existing DCW, please provide your PPL ID.
3. Answer the required program qualifications: indicate if you are a spouse, legal guardian, representative payee, or power of attorney to the participant. Also, confirm your age by selecting 'Yes' or 'No' for the question regarding being under 18 years old.
4. Fill in the participant's information, including their first name, last name, PPL ID (if known), Medicaid number, and any common law employer name, if applicable.
5. Provide your direct care worker information. This includes your first name, middle initial, last name, maiden or alias names, physical address (no P.O. Box), city, state, zip code, county, school district, municipality, mailing address (if different), phone number, alternate phone number, email address, Social Security number, date of birth, gender, and race.
6. Complete the relationship to the participant/common law employer section by checking the appropriate box.
7. Provide your wage information for at least one service you will be providing. Enter the service procedure code and your hourly wage for each service.
8. Answer the questions under the DCW tax information section regarding residency in certain states and eligibility for tax forgiveness.
9. Fill in the DCW record check information, answering questions about minors living with the participant and residency duration in Pennsylvania.
10. Acknowledge the truthfulness of your application responses by signing and dating at the end of the form.
11. Once all fields are completed, save your changes. You may also download, print, or share the completed form as needed.

Begin completing the Dcw Fillable Application Packet online today to ensure a smooth application process.