Oregon

Participant Employer Forms

Form 2678 Form 8821 Form SS-4 Form W-9 OR Client & Employer Change Information Form OR DOR Tax Information Authorization Form OR Employee Termination Form OR ICP Acumen Authorization Form OR ICP Cash Benefit Auto Withdrawal Form OR ICP Cash Benefit Payment Agreement OR ICP EVV Only Report Schedule 2022 to 2023 OR ICP Employer Agreement Form OR ICP Payroll Schedule 2022 to 2023 OR ICP Request for Vendor Reimbursement Form OR Individual & Employer Business Information OR SUTA POA -FORM 2553 Rev 03 OR Tax Authorization Rep Form

Direct Care Employee Forms

Form I-9 Form OR-W-4 Form W-4 OR Employee Change Information Form OR ICP Employee Agreement Form OR Pay Selection & Direct Deposit Form