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Get Stavros Portal User Agreement

STAVROS PORTAL USER AGREEMENT EMPLOYER You have selected to utilize the Stavros Portal to submit your PCA timesheets to the Stavros Fiscal Intermediary for processing. You will be assigned a temporary password which you should change the first time you log into the Stavros Portal. By signing below you agree to the following I understand that I may submit my timesheets via the Stavros Portal I also understand I may choose to submit them by fax or by mail I agree that when I log into the Stavros Portal that I will establish my own password and that I will keep this password confidential I agree that an electronic signature is an acceptable form of approval for each timesheet submitted will use this signature to authorize approve and sign my electronic timesheets I further agree that I will continue to abide by all the terms of the Fiscal Intermediary Agreement I have already signed and that I understand all my responsibilities as listed in that agreement. ACUERDO DEL USO DEL PORTAL DE STAVROS Usted ha seleccionado utilizar el Portal de Stavros para enviar sus hojas de tiempo de PCA al intermediario fiscal de Stavros para ser procesadas. A usted se le asignar una contrase a temporera la cual usted puede cambiar la primera vez que usted use el Portal de Stavros. Firmando abajo usted esta de acuerdo con lo siguiente Yo entiendo que puedo enviar mis hojas de tiempo al Portal de Stavros yo tambi n entiendo que puedo escoger la opci n de enviarlas por fax o por correo. Yo estoy de acuerdo que cuando yo vaya al Portal de Stavros yo escoger mi propia contrase a y mantendr la contrase a confidencial* tiempo enviada* usare esta firma para autorizar aprobar y firmar m hoja de tiempo electr nicamente. que yo he firmado y entiendo todas mis responsabilidades que estan escritas en el acuerdo. Signature/Firma Date/Fecha Name print /Nombre en letra de molde E-mail address/Correo electr nico Please check one /Favor de escoger una I am a PCA Consumer my four digit Employer Number is / Yo soy un Consumidor de PCA los cuatro N meros del empleador es I am a Surrogate for a PCA Consumer their four digit Employer Number is / Yo soy el Tutor/a para el Consumidor de PCA sus cuatro N meros del empleador es I am a PCA employed by a Consumer in the F*I. ACUERDO DEL USO DEL PORTAL DE STAVROS Usted ha seleccionado utilizar el Portal de Stavros para enviar sus hojas de tiempo de PCA al intermediario fiscal de Stavros para ser procesadas. A usted se le asignar una contrase a temporera la cual usted puede cambiar la primera vez que usted use el Portal de Stavros. A usted se le asignar una contrase a temporera la cual usted puede cambiar la primera vez que usted use el Portal de Stavros. Firmando abajo usted esta de acuerdo con lo siguiente Yo entiendo que puedo enviar mis hojas de tiempo al Portal de Stavros yo tambi n entiendo que puedo escoger la opci n de enviarlas por fax o por correo. Firmando abajo usted esta de acuerdo con lo siguiente Yo entiendo que puedo enviar mis hojas de tiempo al Portal de Stavros yo tambi n entiendo que puedo escoger la opci n de enviarlas por fax o por correo. Yo estoy de acuerdo que cuando yo vaya al Portal de Stavros yo escoger mi propia contrase a y mantendr la contrase a confidencial* tiempo enviada* usare esta firma para autorizar aprobar y firmar m hoja de tiempo electr nicamente. .

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