Get Ccis Employment Verification Form

Get Ccis Employment Verification Form

The CCIS Employment Verification Form is a document used to confirm an employee's job status and income, primarily for the purpose of determining eligibility for subsidized child care assistance. This form requires detailed information from both the employer and the employee, including work schedules, pay rates, and employment duration. Completing this form accurately is essential for employees seeking financial support for child care, so be sure to fill it out by clicking the button below.

Structure

The CCIS Employment Verification Form plays a crucial role in determining an employee's eligibility for subsidized child care assistance. This form requires specific information from both the employee and the employer. Essential details include the employer's name, address, and contact information, as well as the employee's job title and employment start date. The form also asks for the employee's income, including hourly rates and gross pay, along with a breakdown of their work schedule. Employers must indicate whether the employee is newly hired, on extended leave, or considered temporary or seasonal. A clear record of hours worked, specified in either A.M. or P.M., is vital for accurate verification. The completion of this form is mandatory and must be submitted directly to the Early Learning Resource Center (ELRC) by an authorized company representative. This process ensures that the information provided is reliable and helps streamline access to necessary child care support.

Ccis Employment Verification Preview

 

 

 

 

 

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.

from_________ a.m./p.m. to_________

a.m./p.m.

Wed.

from_________ a.m./p.m. to_________

a.m./p.m.

Thur.

from_________ a.m./p.m. to_________

a.m./p.m.

Fri.

from_________ a.m./p.m. to_________

a.m./p.m.

Sat.

from_________ a.m./p.m. to_________

a.m./p.m.

Sun.

from_________ a.m./p.m. to_________

a.m./p.m.

TOTAL # HOURS/WEEK: _________________________

WEEK TWO

Dates: from:__________________

 

 

to:____________________

Mon.

from_________ a.m./p.m. to_________

a.m./p.m.

Tues.

from_________ a.m./p.m. to_________

a.m./p.m.

Wed.

from_________ a.m./p.m. to_________

a.m./p.m.

Thur.

from_________ a.m./p.m. to_________

a.m./p.m.

Fri.

from_________ a.m./p.m. to_________

a.m./p.m.

Sat.

from_________ a.m./p.m. to_________

a.m./p.m.

Sun.

from_________ a.m./p.m. to_________

a.m./p.m.

TOTAL # HOURS/WEEK: _________________________

WEEK THREE

Dates: from:__________________

 

 

to:____________________

Mon.

from_________ a.m./p.m. to_________

a.m./p.m.

Tues.

from_________ a.m./p.m. to_________

a.m./p.m.

Wed.

from_________ a.m./p.m. to_________

a.m./p.m.

Thur.

from_________ a.m./p.m. to_________

a.m./p.m.

Fri.

from_________ a.m./p.m. to_________

a.m./p.m.

Sat.

from_________ a.m./p.m. to_________

a.m./p.m.

Sun.

from_________ a.m./p.m. to_________

a.m./p.m.

TOTAL # HOURS/WEEK: _________________________

WEEK FOUR

Dates: from:__________________

 

 

to:____________________

Mon.

from_________ a.m./p.m. to_________

a.m./p.m.

Tues.

from_________ a.m./p.m. to_________

a.m./p.m.

Wed.

from_________ a.m./p.m. to_________

a.m./p.m.

Thur.

from_________ a.m./p.m. to_________

a.m./p.m.

Fri.

from_________ a.m./p.m. to_________

a.m./p.m.

Sat.

from_________ a.m./p.m. to_________

a.m./p.m.

Sun.

from_________ a.m./p.m. to_________

a.m./p.m.

TOTAL # HOURS/WEEK: _________________________

Effective begin date of schedule change:

EXTENDED LEAVE

Is the employee on extended leave (maternity, disability, etc.)?

Yes

No

Effective begin date of extended leave: ___ / ___ / ______

Date returned from extended leave: ___ / ___ / ______

TEMPORARY/SEASONAL EMPLOYMENT

Is the employee considered to be a temporary hire?

Yes

No

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

 

 

DATE

 

CY 925 6/19

Employment Verification Form

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

CY 925 6/19

Document Data

Fact Name Details
Purpose The Ccis Employment Verification Form is used to verify an employee's employment status for subsidized child care assistance.
Employer Responsibility The employer must complete the form, ensuring all information is accurate and submitted directly to the Early Learning Resource Center (ELRC).
Authorized Personnel An authorized company representative, not the employee, must fill out the form to ensure validity.
Information Required Key details such as employer identification number, employee job title, and employment income must be provided.
Work Schedule Employers are required to specify the employee’s work schedule, including days and hours worked, indicated as A.M. or P.M.
Extended Leave The form includes a section to indicate if the employee is on extended leave, such as maternity or disability leave.
Temporary Employment Employers must clarify if the employee is temporary or seasonal, along with relevant dates related to their employment.
Submission Process The completed form must be mailed directly to the ELRC to facilitate the employee’s eligibility for child care subsidies.
Contact Information Employers can reach out to the ELRC for assistance with the form at (610) 278-3707 or (800) 281-1116.

How to Use Ccis Employment Verification

Completing the Ccis Employment Verification form is a straightforward process. This form is essential for verifying employment details, which will be used to assess eligibility for subsidized child care. Follow the steps below to ensure accurate and complete information is provided.

  1. Begin by entering the Employer Name/Place of Employment at the top of the form.
  2. Fill in the Immediate Supervisor’s Name and Title.
  3. Provide your Employee’s Printed Name and have the employee sign and date the form.
  4. In the section for the employer, enter the Employer Identification Number (EIN).
  5. Complete the Address of Employment and the Employer’s Telephone Number.
  6. Indicate the Employee’s Job Title and whether the employee is newly hired by selecting 'Yes' or 'No.'
  7. Fill in the Employment Start Date.
  8. Record the Hourly Rate, Gross Pay, Average Daily Tips, and the Next Pay Date.
  9. Select the Pay Frequency from the options provided.
  10. Indicate how the employee receives their pay by checking the appropriate boxes.
  11. Provide a detailed Employment Schedule for the employee, including days and hours worked for four weeks.
  12. Answer questions regarding Extended Leave and Temporary/Seasonal Employment as applicable.
  13. Finally, the employer must print their name and job title, sign, and date the form.

Once completed, the form must be mailed directly to the Early Learning Resource Center (ELRC). Ensure all sections are filled out accurately to avoid delays in processing the employee's request for subsidized child care assistance.

Key Facts about Ccis Employment Verification

What is the purpose of the CCIS Employment Verification Form?

The CCIS Employment Verification Form is used to confirm an employee's job details and income. This information helps determine if the employee qualifies for subsidized child care assistance through the Early Learning Resource Center (ELRC).

Who needs to complete the form?

An authorized company representative, not the employee, must fill out the form. This ensures that the information provided is accurate and verified by someone in a position of authority.

What information is required from the employer?

The employer must provide details such as the employer's name, address, phone number, and the employee's job title. They also need to include the employee's income, work schedule, and any information about extended leave or temporary employment status.

How should the work schedule be reported?

The work schedule should be detailed, indicating specific days and hours worked. If the employee's hours vary, a four-week sample schedule is required. It’s important to specify whether the hours are in the A.M. or P.M.

What if the employee does not receive paystubs?

If the employee does not receive paystubs, this should be clearly indicated on the form. The employer can also mention if the employee receives pay in cash or has access to online pay information.

What happens if the employee is on extended leave?

If the employee is on extended leave, the employer must indicate this on the form. They should provide the effective dates of the leave and the date the employee is expected to return to work.

Is there a specific format for reporting income?

Yes, the employer must report the employee's hourly rate, gross pay, and any average daily tips. This information helps establish the employee's financial situation for the subsidized child care program.

What if the employee is a temporary or seasonal hire?

The employer should indicate if the employee is temporary or seasonal. They must provide the last date of guaranteed employment for temporary hires or the last day of work before a break for seasonal employees, along with the expected return date.

How should the completed form be submitted?

The completed form must be mailed directly to the Early Learning Resource Center (ELRC). It should not be returned to the employee. The ELRC's contact information is provided on the form for any questions.

What if I have more questions about the form?

If you have questions about completing the form, you can contact the ELRC directly. Their phone number is (610) 278-3707 or (800) 281-1116. They can provide guidance and assistance as needed.

Common mistakes

Filling out the CCIS Employment Verification form can be straightforward, but there are common mistakes that can lead to delays or complications. One frequent error is not providing the employer identification number (EIN). This number is essential for proper identification and processing. Without it, the form may be considered incomplete.

Another common mistake is failing to include the immediate supervisor's name and title. This information helps verify the employee's position and ensures that the verification process is accurate. Omitting this detail can lead to unnecessary back-and-forth communication.

Many people also forget to indicate whether the employee is newly hired. This information is crucial for the Early Learning Resource Center (ELRC) to assess eligibility for assistance. If this section is left blank, it may cause delays in processing the application.

Inaccuracies in the employment schedule are another area where mistakes often occur. It is vital to specify the days and hours the employee works clearly. If the schedule varies, providing a four-week sample is necessary. Incomplete or vague entries can result in confusion and further inquiries.

Some individuals neglect to clarify the pay frequency and income details. This includes the hourly rate, gross pay, and average daily tips. Missing or incorrect figures can complicate the verification process and may lead to misunderstandings regarding the employee's financial situation.

Another oversight involves the extended leave section. Employers must indicate if the employee is on extended leave and provide the relevant dates. Failing to do so can hinder the assessment of the employee's eligibility for child care assistance.

Lastly, the form must be signed by an authorized company representative, not the employee. This is a critical requirement. If the signature is missing or incorrect, the form will not be accepted, causing delays in the assistance process. Attention to detail is essential when completing this form to ensure a smooth verification process.

Documents used along the form

The CCIS Employment Verification form is an essential document used to confirm an employee's job status and income for child care assistance programs. Alongside this form, several other documents may be required to provide a comprehensive view of the employee's situation. Below is a list of commonly associated forms and documents.

  • Pay Stubs: These documents provide detailed information about an employee's earnings for a specific pay period. They show gross pay, deductions, and net pay, helping to verify income accurately.
  • W-2 Form: Issued by employers, the W-2 form summarizes an employee's annual earnings and the taxes withheld. It is crucial for determining overall income and tax obligations.
  • Job Offer Letter: This document outlines the terms of employment, including job title, salary, and start date. It serves as proof of employment and the conditions agreed upon at hiring.
  • Employee Contract: If applicable, this document details the terms of employment, including duration, responsibilities, and compensation. It provides a legal framework for the employee's role within the company.
  • Time Sheets: These records track the hours worked by an employee, often used for payroll purposes. They can help confirm the employee's work schedule and hours when verifying employment details.

Collecting these documents, along with the CCIS Employment Verification form, ensures a complete and accurate assessment of an employee's eligibility for subsidized child care. It is important to maintain clear records for both the employee and employer to facilitate the verification process.

Similar forms

  • W-2 Form: This document provides information about an employee's annual wages and the taxes withheld. Similar to the Employment Verification Form, it confirms employment status and income, which can be essential for various applications, including financial aid.
  • Pay Stubs: Pay stubs detail the employee's earnings for each pay period. Like the Employment Verification Form, they serve as proof of income and employment, often required for loan applications or rental agreements.
  • I-9 Form: The I-9 verifies an employee's identity and eligibility to work in the U.S. While the Employment Verification Form focuses on employment details, both documents confirm that the individual is employed and legally allowed to work.
  • Employment Letter: An employment letter is a formal document from an employer confirming an employee's job title, salary, and employment duration. Similar to the Employment Verification Form, it serves as proof of employment for various purposes.
  • Job Offer Letter: This letter outlines the terms of employment, including job title and salary. It provides initial proof of employment, similar to the Employment Verification Form, which confirms ongoing employment and details about the job.
  • Reference Letter: A reference letter from an employer can provide insight into an employee's work ethic and performance. While it differs in purpose, both documents can support job applications or financial assistance requests.
  • Employer Verification Letter: This document is specifically designed to confirm an employee's job status and income. It closely resembles the Employment Verification Form in its purpose and the information it provides.
  • Tax Returns: Personal tax returns include income information that can verify employment. While they offer a broader view of financial status, they, like the Employment Verification Form, can be used to confirm income for various applications.
  • Contract of Employment: This document outlines the terms of employment, including salary and job responsibilities. Both the contract and the Employment Verification Form confirm the employee's role and compensation.
  • Unemployment Verification Form: This form is used to verify an individual's previous employment when applying for unemployment benefits. It shares the purpose of confirming employment history, similar to the Employment Verification Form.

Dos and Don'ts

When filling out the CCIS Employment Verification form, it's essential to follow certain guidelines to ensure accuracy and compliance. Here are five things you should and shouldn't do:

  • Do provide complete and accurate information for all required fields.
  • Do ensure that the employer's printed name and job title are clearly written.
  • Do specify the employee's work schedule, including A.M. or P.M. designations.
  • Do double-check the dates for accuracy, especially for employment start and leave dates.
  • Do submit the form directly to the Early Learning Resource Center (ELRC) as instructed.
  • Don't leave any required sections blank; incomplete forms can delay processing.
  • Don't provide vague or unclear information about the employee’s work schedule.
  • Don't sign the form without confirming that all information is accurate.
  • Don't submit the form without the signature of an authorized company representative.
  • Don't forget to include the employer identification number (EIN) if required.

Misconceptions

Understanding the CCIS Employment Verification Form can be crucial for both employers and employees. However, several misconceptions can lead to confusion. Here’s a breakdown of six common misunderstandings:

  • Only Employers Need to Fill It Out: Many people think that only the employer is responsible for the form. In reality, both the employee and employer must provide accurate information for it to be valid.
  • The Form is Only for New Hires: Some believe this form is only necessary for new employees. However, it can be required for any employee seeking assistance with child care costs, regardless of their tenure.
  • Pay Stubs are Not Necessary: A common misconception is that pay stubs are optional. In fact, the form specifically asks whether the employee receives pay stubs, which is important for verifying income.
  • It Can Be Submitted by the Employee: Many assume that employees can submit the form themselves. However, the form must be completed and signed by an authorized company representative, not the employee.
  • All Employment Details are Optional: Some individuals think that they can skip certain sections of the form. In truth, all sections must be filled out accurately to ensure proper verification.
  • It’s Only About Income: While income is a significant part of the form, it also requires detailed information about the employee’s work schedule and employment status, which are equally important for determining eligibility for child care assistance.

By clarifying these misconceptions, both employers and employees can navigate the CCIS Employment Verification Form more effectively. Understanding the requirements ensures a smoother process for everyone involved.

Key takeaways

When filling out the CCIS Employment Verification form, there are several important points to keep in mind. Here’s a list of key takeaways to ensure a smooth process:

  • Complete Information: Ensure that all sections of the form are filled out accurately. Missing information can delay the verification process.
  • Employer Details: Provide the employer's name, address, and contact information. This helps the Early Learning Resource Center (ELRC) reach out if they have questions.
  • Employee Authorization: The employee must sign the form to authorize the release of their information. Without this signature, the verification cannot proceed.
  • Job Title and Start Date: Clearly indicate the employee’s job title and their employment start date. This establishes their tenure with the company.
  • Income Information: Include the employee's hourly rate, gross pay, and any average daily tips. This data is crucial for determining eligibility for subsidized child care.
  • Pay Frequency: Specify how often the employee is paid—weekly, bi-weekly, or monthly. This helps clarify the employee’s income flow.
  • Work Schedule: Provide a detailed work schedule, including days and hours worked. Be specific about whether hours are A.M. or P.M.
  • Extended Leave: If applicable, indicate whether the employee is on extended leave and provide relevant dates. This information can affect their eligibility.
  • Temporary or Seasonal Employment: If the employee is temporary or seasonal, it’s important to note this and provide the last date of guaranteed employment.
  • Submission Process: Remember that the completed form must be mailed directly to the ELRC. An authorized company representative should submit it, not the employee.

By keeping these points in mind, you can help ensure that the employment verification process goes smoothly and efficiently.