Get Ia 470-4429 2008-2025

Filling out the IA 470-4429 form online is a crucial step in documenting hours worked for services provided to individuals under the Medicaid program. This guide will assist you in completing the form accurately and efficiently.

Follow the steps to complete the IA 470-4429 online

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Provide the employer or Medicaid number in the designated field.
3. Enter the employee's name in the 'Employee' section.
4. Fill in the employee's Social Security number.
5. Specify the position of the employee.
6. Input the employee's hourly wage.
7. Enter the employer’s first and last name.
8. Indicate the pay period by filling in the relevant dates.
9. Document the start and end times for each work period under the provided sections.
10. Calculate and enter the total hours worked for each entry.
11. State the rate of pay corresponding to the hours worked.
12. Provide a narrative of services provided, ensuring alignment with the individual budget.
13. Record any progress or changes observed regarding the service recipient.
14. Certify the information by signing where indicated for both the employee and employer.
15. Finally, save changes, download, print, or share the completed form as necessary.

Complete your IA 470-4429 form online today for timely processing.