INCOME VERIFICATION FOR HOUSEHOLD EMPLOYEES

 

This form is for payments paid January-December.

By signing this form, I agree that the information provided is true and correct to the best of my ability.

I understand the information on this form will be submitted to the IRS for income verification.

The IRS may require additional information from me later time on behalf of the client.

HOUSEHOLD EMPLOYEE INCOME VERIFICATION WORKSHEET

What is a household employee? If you work for someone at their home and he/she controls what work is done, how you did the work and you made less than $2,400 per household and you did not have to purchase any supplies or make any expenses, you are considered a household employee and NOT self-employed.

Example of household employees/workers: babysitters, nannies, caretakers, maids, housekeepers, domestic workers, drivers, health aides, private nurses, private sitters, groundkeepers, yard workers, etc

If any one person you worked for paid you $2,200 or more for the entire year, they must provide the tax preparer with a w2, but if you worked for multiple people and they paid you less than $2,400, please provide us the total amount you were paid from all employers that year combined.

We ask you to bring this form completed and two signed verification letters from your employers.

Amount you collectively received for the year from employer(s): $ Ledger of payments from employer/employment verification for service(s) provided during (tax year) January-December

Employer's Name (Person who paid you)

Service(s) Provided to Employer

Method of payment received Cash, Check, MO

By signing this form, I agree that the information provided is true and correct to the best of my ability. I understand that I am responsible for keeping a record of payment for services provided for 3 years. Ihave been advised by my tax preparer that the IRS may require additional verification as proof of income at a later date and it is my responsibility to provide if it is requested.