[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-283837-105":53,"doc-detail-283837-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","hilltop-veteran-directed-care-employer-packet-rev-124","Hilltop Veteran Directed Care - Employer Packet - Rev. 1/24","","Hilltop Veteran Directed Care employer paperwork packet provides a checklist of required forms and step-by-step guidance for completing them. It specifies that authorized representatives must complete Sections 1 and 2 as applicable and that veterans sign and date the form when required. The packet lists IRS and unemployment-related authorization documents, including Form SS-4 instructions and ongoing submission options for mailing, email, or fax to Premier Financial Management Services.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/hilltop-veteran-directed-care-employer-packet-rev-124/283837/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/hilltop-veteran-directed-care-employer-packet-rev-124/283837.png","ImageObject",442,249,{"name":88,"@type":89},"Margaret","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-22","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"Which documents are required in the Hilltop Veteran Directed Care employer packet?","Question",{"text":109,"@type":110},"The packet lists required forms including Authorized Representative Form, Form SS-4, Form 2678, Form 8821, DR0145, and UITL-18.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How should the Authorized Representative form be completed and signed?",{"text":114,"@type":110},"Fill in Sections 1 and 2 where applicable. Veterans must sign and date at the bottom, and if an Authorized Representative exists, the AR must also sign and date.",{"name":116,"@type":107,"acceptedAnswer":117},"Where and how do you submit the completed paperwork?",{"text":118,"@type":110},"Submit the completed forms to Premier Financial Management Services by mail to the listed Milwaukee address or by email or fax using the contact information provided.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},283837,1791592738,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":141,"read_time":79},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","hilltop Veteran Directed Care veteran PAPERWORK CHECKLIST  \n\n| DOCUMENT NAME | REQUIRED/OPTIONAL |\n| --- | --- |\n| Authorized Representative Form | Required |\n| Form SS-4: Application for Employer Identification Number | Required |\n| Form 2678: Employer/Payer Appointment of Agent | Required |\n| Form 8821: Tax Information Authorization | Required |\n| Form DR0145: Tax Information Designation and Power of Attorney for Representation | Required |\n| Form UITL-18: Power of Attorney for Unemployment Insurance | Required |\n\nNote:  \nPlease ensure all REQUIRED documents are filled out accurately before submitting them for processing.  \n10425 W. North Ave. Ste. 345, Milwaukee, WI 53226 | Phone: (855) 287-6638 | Fax: (855) [334-3866](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)[ |](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)[ MesaCoVDC@premier-fms.com](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)[ |](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)[ www.premier-fms.com](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)[ ](334-3866 | MesaCoVDC@premier-fms.com | www.premier-fms.com)Hilltop Veteran Directed Care Veteran Packet-Rev. 1/24  \nAuthorized Representative form  \nInstructions: Please fill out any information in Sections 1 and 2, where applicable. Veterans are required to sign and date at the bottom of the form. If a Veteran has an Authorized Representative, the AR must also sign and date the form. Please submit the completed form to Premier Financial Management Services (Premier FMS) via one of the following options below:  \nMail:  \n10425 W North Ave. Suite 345  \nMilwaukee, WI 53226  \nEmail:  \n[MesaCoVDC@premier-fms.com](MesaCoVDC@premier-fms.com)  \nFax:  \n(855) 334-3866  \nApplication for Employer Identification Number OMB No. 1545-0003  \n(For use by employers, corporations, partnerships, trusts, estates, churches, EIN  \ngovernment agencies, Indian tribal entities, certain individuals, and others.)  \nDepartment of the Treasury See separate instructions for each line. Keep a copy for your records.  \nInternal Revenue Service [Go to](Go to www.irs.gov/FormSS4 for)[ www.irs.gov/FormSS4](Go to www.irs.gov/FormSS4 for)[ for](Go to www.irs.gov/FormSS4 for) instructions and the latest information.  \n1 Legal name of entity (or individual) for whom the EIN is being requested  \n2 Trade name of business (if different from name on line 1) 3 Executor, administrator, trustee,“care of” name  \n4a Mailing address (room, apt., suite no. and street, [or P.O. box](or P.O. box)) 5a Street address (if different) (Don’[t enter a P.O. box](t enter a P.O. box).)  \n4b City, state, and ZIP code (if foreign, see instructions) 5b City, state, and ZIP code (if foreign, see instructions)  \n6 County and state where principal business is located  \n7a Name of responsible party 7b SSN, ITIN, or EIN  \n8a Is this application for a limited liability company (LLC)  \n(or a foreign equivalent)? . . . . . . . . Yes No  \n8b  \nIf 8a is “Yes,” enter the number of LLC members . . . . . . .  \nPremier Financial Management Services  \n10425 W North Ave 345  \nMilwaukee, WI 53226  \nForm SS-4  \n(Rev. December 2023)  \n✔  \nType or print clearly.  \n8c If 8a is “Yes,” was the LLC organized in the United States? . . . . . . . . . . . . . . . . . .  Yes  No  \n9a Type of entity (check only one box) . Caution: If 8a is “Yes,” see the instructions for the correct box to check.  \n Sole proprietor (SSN)    Estate (SSN of decedent)    \n Partnership  Plan administrator (TIN)    \n Corporation (enter form number to be filed)    Trust (TIN of grantor)    \n Personal service corporation  Military/National Guard  State/local government  \n Church or church-controlled organization  Farmers’ cooperative  Federal government  \n Other nonprofit organization (specify)    REMIC  Indian tribal governments/enterprises  \n✔ Other (specify) HHCSR Group Exemption Number (GEN) if any  \n| 9b | If a corporation, name the state or foreign country (if applic","cbCaiihKTLt2SCXZ","https://ap.wps.com/l/cbCaiihKTLt2SCXZ","pdf",867626,10,"English","# Authorized Representative form\n## Required paperwork checklist\n## Submission instructions\n# Application for Employer Identification Number (Form SS-4)\n## Key fields and instructions","[{\"question\":\"Which documents are required in the Hilltop Veteran Directed Care employer packet?\",\"answer\":\"The packet lists required forms including Authorized Representative Form, Form SS-4, Form 2678, Form 8821, DR0145, and UITL-18.\"},{\"question\":\"How should the Authorized Representative form be completed and signed?\",\"answer\":\"Fill in Sections 1 and 2 where applicable. Veterans must sign and date at the bottom, and if an Authorized Representative exists, the AR must also sign and date.\"},{\"question\":\"Where and how do you submit the completed paperwork?\",\"answer\":\"Submit the completed forms to Premier Financial Management Services by mail to the listed Milwaukee address or by email or fax using the contact information provided.\"}]","Hilltop Veteran Directed Care - Employer Packet - Rev. 1/24 | PDF",1789620618]