Below are links to documents and forms commonly used by consumers and attendants. Please feel free to print, complete, and return to the proper staff.

 

FOR CONSUMER-DIRECTED SERVICES CONSUMERS & ATTENDANTS

Federal W-4

Form used to alter Federal withholding from the attendant's paycheck.

Missouri W-4

Form used to alter Missouri withholding from the attendant's paycheck.

Direct Deposit

Form used to begin Direct Deposit of attendant's paycheck into his/her bank account.

2010 Pay Schedule

Form used to track timesheets, the date in which they are due, and when they are paid.

Emergency Plan

Form used to track emergency contacts, phone numbers, medications, conditions, and emergency preparedness procedures.

 


 

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NorthEast Independent Living Services
 

KAHOKA-BRANCH OFFICE
288 E Main St
Kahoka, MO 63445
Phone/TTY: (660) 727-2090
Toll Free: (866) 727-6088
Fax: (660) 727-2099
HANNIBAL-HOME OFFICE
909 Broadway Suite 350
Hannibal, MO 63401
Phone/TTY: (573) 221-8282
Toll Free: (877) 713-7900
Fax: (573) 221-9445
 

QUALITY IN-HOME CARE
909 Broadway, Ste 300
Hannibal, MO 63401
Phone/TTY: (573) 221-4242
Toll Free: (877) 721-4242
Fax: (573) 221-4248

 

NorthEast Independent Living Services does not discriminate on the basis of race, color, national origin, religion, sex, sexual orientation, disability type, age, veteran status, medical condition, citizenship, ancestry, or marital status.

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