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ATTACHMENT SAMPLE REQUEST FOR APPLICATIONPROVIDERS OF SERVICES FOR CHILDREN AND FAMILIES UNDER THE EARLY INTERVENTION PROGRAMISSUE DATE:PROPOSALS DUE: CONTRACT PERIOD:REQUEST FOR APPLICATION PROVIDERS
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Providers of services is for reporting information on payments made for services provided.
Entities that make payments for services are required to file providers of services form.
Providers of services form can be filled out online or submitted through mail with required information on payments made for services.
The purpose of providers of services form is to report payments made for services for tax purposes.
Information such as the name, address, and tax identification number of the service provider, as well as the total amount paid for services, must be reported on providers of services form.
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