The Ccis Employment Verification form is a crucial document designed to verify employment details for employees seeking assistance with child care costs through the Early Learning Resource Center (ELRC). It ensures a thorough account of employment, including job title, income, schedule, and the possibility of extended leave or temporary employment status, by requiring an employer’s direct input. For accurate assistance in completing this form, click the button below.
The Ccis Employment Verification form is a crucial document designed to facilitate the assessment of an employee’s eligibility for subsidized child care programs. It requires detailed information from employers about their employees' work situation, including the employer's name, supervisor details, and specifics about the employee's job title, start date, pay, and work schedule. Employers are asked to provide a clear picture of the income and work hours of the employee, distinguishing between regular pay, tips, and the frequency of paychecks. For accurate scheduling information, a four-week sample schedule may be required to capture any variations in work hours. Additionally, the form touches on scenarios such as extended leave and temporary or seasonal employment to understand the employee's work status fully. Employers play a significant role in this process by authorizing and submitting this information to the Early Learning Resource Center (ELRC), which uses the details to determine the employee’s eligibility for child care cost assistance. This form not only underlines the importance of accurate employment verification in supporting child care assistance programs but also emphasizes the collaborative effort between employers, employees, and social support systems in ensuring that working parents have the necessary support for their child care needs.
Employment Verification Form
EMPLOYER NAME/PLACE OF EMPLOYMENT:
IMMEDIATE SUPERVISOR’S NAME:
IMMEDIATE SUPERVISOR’S TITLE:
I authorize the release of this information and give permission to the Early Learning Resource Center (ELRC) to verify all information contained in this form.
EMPLOYEE’S PRINTED NAME
EMPLOYEE’S SIGNATURE
DATE
THE FOLLOWING SECTIONS MUST BE COMPLETED BY THEIR EMPLOYER
EMPLOYER IDENTIFICATION NUMBER (EIN):
ADDRESS OF EMPLOYMENT:
EMPLOYER’S TELEPHONE NUMBER:
(______) ______ - ____________
EMPLOYEE INFORMATION
EMPLOYEE’S JOB TITLE:
Is the above-mentioned employee newly hired?
Yes
No
EMPLOYMENT START DATE:
______ / ______ / ____________
EMPLOYMENT INCOME
HOURLY RATE:
GROSS PAY:
AVERAGE DAILY TIPS:
NEXT PAY DATE:
PAY FREQUENCY:
$
___ / ___ / ______
Weekly
Bi-Weekly (26 pays/year)
Twice a Month (24 pays/year)
Monthly
The employee: receives paystubs does NOT receive paystubs receives pay in CASH has access to pay online via the following website:
EMPLOYMENT SCHEDULE (Please indicate the days and hours the employee works and indicate whether the hours occur during A.M. or P.M.)
NOTE: If the schedule varies, please give a 4-week sample schedule.
WEEK ONE
Dates: from:__________________
to:____________________
Mon.
from_________ a.m./p.m. to_________
a.m./p.m.
Tues.
Wed.
Thur.
Fri.
Sat.
Sun.
TOTAL # HOURS/WEEK: _________________________
WEEK TWO
WEEK THREE
WEEK FOUR
Effective begin date of schedule change:
EXTENDED LEAVE
Is the employee on extended leave (maternity, disability, etc.)?
Effective begin date of extended leave: ___ / ___ / ______
Date returned from extended leave: ___ / ___ / ______
TEMPORARY/SEASONAL EMPLOYMENT
Is the employee considered to be a temporary hire?
If the employee is considered a temporary hire, what is the last date of guaranteed employment? ___ / ___ / ______
If the employee is seasonal, please give: Last day of work before break: ___ / ___ / ______
Expected date of return following break: ___ / ___ / ______
I understand that the information I am providing will be used to determine the above-named employee’s eligibility for
subsidized child care.
EMPLOYER’S PRINTED NAME & JOB TITLE
EMPLOYER’S SIGNATURE
CY 925 6/19
Dear Employer:
One of your employees has requested assistance paying his/her child care costs. We must verify his/her employment with you. This information will help us determine if this employee is eligible for the subsidized child care program. The form must be mailed directly to the Early Learning Resource Center (ELRC).
An authorized COMPANY REPRESENTATIVE (not the employee) must complete this form.
We must have an accurate record of your employee’s work schedule and employment income. Please complete the information on the back of this page. It is very important that the hours shown are specific and defined as either A.M. or P.M. (For example, 7:30 a.m. - 3:30 p.m.). If the employee’s schedule varies, please give a 4-week sample schedule. You do not need to give a 4-week sample schedule unless the employee’s schedule varies from week to week.
Thank you for your time and assistance. If you have any questions about how to complete this form, please contact the ELRC listed below.
ELRC:
Early Learning Resource Center Region 17
PO Box 311
1430 DeKalb Street
Norristown, PA 19404-0311
(610)278-3707 or (800) 281-1116 Fax (610) 278-5161
When an employee seeks financial help for child care costs, verification of their employment status and schedule is required. This process involves accurately filling out the Employment Verification Form and mailing it directly to the Early Learning Resource Center (ELRC). The form gathers essential details about the employee's job title, employment duration, income, and work schedule to aid in determining eligibility for subsidized child care programs. Employers or their authorized representatives are responsible for providing this information. Ensuring that the details are specific, clear, and complete is crucial for a smooth verification process.
Once the form is completed, it is essential to mail it directly to the designated ELRC as indicated on the form. This step is vital for the timely processing of the employee's application for subsidized child care assistance. Employers who require assistance or have questions about completing the form should not hesitate to contact the ELRC for guidance.
The CCIS Employment Verification Form is designed to authenticate an employee's job status and details for the Early Learning Resource Center (ELRC) primarily to establish eligibility for subsidized child care programs. It serves as a formal request to verify employment information including job title, income, schedule, and if the employment is temporary or seasonal. By accurately completing and submitting this form, employers assist their employees in potentially securing financial aid for child care costs, enabling them to continue working.
Completion of the CCIS Employment Verification Form must be carried out by an authorized company representative, not the employee who is requesting assistance for child care costs. This representative is tasked with providing detailed information regarding the employee's work schedule, income, and the nature of their employment (e.g., temporary, seasonal, or on extended leave). It's critical that the information given is accurate and comprehensive, as it directly impacts the employee's eligibility for the child care subsidy.
The completed CCIS Employment Verification Form must be mailed directly to the Early Learning Resource Center (ELRC) at the address provided on the form itself. It is of utmost importance that the form is sent from the employer's address and not by the employee seeking the child care subsidy. This procedure ensures the confidentiality and integrity of the verification process. The address for submission is: Early Learning Resource Center Region 17, PO Box 311, 1430 DeKalb Street, Norristown, PA 19404-0311. Additionally, for queries or further clarification, employers can contact the ELRC via the telephone numbers or fax number listed on the form.
Filling out the CCIS Employment Verification form accurately is critical for employees seeking assistance with child care costs. However, common mistakes can hinder the process. Here are 10 errors often made when completing this form:
It's essential for both employees and employers to review the CCIS Employment Verification form thoroughly before submission, ensuring all required information is accurate and complete. This attention to detail will help avoid delays or issues with the application for subsidized child care assistance.
When completing the Child Care Information Services (CCIS) Employment Verification form, it's often not the only document required. Numerous other forms and documents are frequently used in conjunction to provide a comprehensive view of an employee's employment status, income, and eligibility for programs such as subsidized child care. Understanding these related documents can help streamline the application process and ensure that all necessary information is accurately conveyed.
Compiling these documents together with the CCIS Employment Verification form requires careful attention to detail and thoroughness. Each piece of documentation serves its specific purpose, from establishing identity and legal work status to providing a detailed account of income and employment schedules. Accurate and timely submission of these documents not only facilitates the verification process but also helps ensure that the assistance goes to those who truly need it. As such, employers and employees must work collaboratively to gather and submit all required information to support their application for subsidized child care programs.
The W-4 form, used for federal tax withholding, is similar as it also requires personal and employment information to be filled out by the employee and is used to inform financial determinations, in this case, tax withholding rates.
The I-9 Employment Eligibility Verification form parallels this document since it is filled out by both the employee and the employer to verify the employee's legal eligibility to work in the United States, involving the verification of worker's personal and employment details.
Payroll Direct Deposit Authorization form shares similarities because it includes employee personal information, employment details, and requires authorization to process employment-related financial transactions, focusing on the disbursement of salaries.
The Background Check Authorization form can be seen as similar because it requires the employee’s consent for the employer to perform a background check, touching on the need for employee information verification for employment purposes.
Employee's Withholding Certificate for State Taxes (varies by state, e.g., California Form DE 4), like the CCIS form, needs employment information and personal details to calculate correct state tax withholdings, evidencing the interconnectedness of employment and financial considerations.
Benefits Enrollment form resembles the CCIS form as both require employee information and involve choices that affect financial aspects of employment, such as health insurance or retirement savings, which impact the employee's compensation package.
The Employment Contract, providing comprehensive details of the employment arrangement including job responsibilities, salary, and work schedule, is akin to the CCIS form in its requirement for detailed employment information to establish the terms of the employment relationship.
Request for Leave of Absence form correlates with the section on extended leave in the CCIS form, as both entail providing employment details and acquiring authorization related to changes in an employee’s work schedule due to leave.
The Job Application form is similar to the extent that it gathers preliminary employment information from candidates, which, if successful, becomes foundational to further employment verification and documentation processes.
The Employee Emergency Information form, while more focused on personal safety, draws parallels with the necessity for employee personal details and the employer's acknowledgement and verification of these details within the organizational context.
When you are filling out the CCIS Employment Verification form, it's crucial to get it right. Below are 10 tips - five things you should do and five things you shouldn't do - to help guide you through the process.
There are several misconceptions regarding the CCIS Employment Verification Form. Understanding these can help both employers and employees ensure the accurate and efficient processing of subsidized child care assistance applications.
It's essential to understand that this form must be completed by an authorized company representative, not by the employee who is applying for subsidized child care assistance. This ensures that all information regarding employment and income is verified and accurate.
While there's a provision to provide a 4-week sample schedule for employees whose work hours vary, it's crucial for employers to provide clear and specific schedules for all employees. This includes defining hours as A.M. or P.M. and providing an effective date for any schedule changes.
Beyond basic employment verification, this form is used to assess the employment stability and income consistency of an applicant for subsidized child care. It includes sections on employment start date, pay frequency, and whether the employee is permanent or temporary, which are all critical for determining eligibility.
Not just any employer representative can sign off on this form — it must be an authorized company representative. This often means someone in a management or human resources position who has direct knowledge of the employee's work schedule, compensation, and employment status.
It's important for employers to carefully read and accurately complete the CCIS Employment Verification Form to support their employees in accessing necessary child care services. Comprehensive and precise information helps streamline the process for everyone involved.
Filling out the CCIS Employment Verification Form accurately is crucial for employees seeking assistance with child care costs through subsidized programs. Here are key takeaways for employers to consider:
By carefully completing the CCIS Employment Verification Form, employers play a significant role in supporting their employees' access to affordable child care options. This not only benefits the employee but can also improve workplace morale and employee retention by addressing one of the critical needs of working parents.
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