JumpStart June 2024 Compliance Form

JumpStart Pay Stub and Payment Statements
All JumpStart participants must be employed and submit proof of employment weekly.

Use this form to upload your pay stubs or proof of pay from your job.

If you need help, call us at 248.469.4004 or email JumpStartDET@gmail.com
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.
Are you currently employed?*

YesNo
Name of Employer*
How long have you been employed at your current job?*

0-30 days (0-1 month)31-90 days (+1 month to 3 months)91-180 days (+3 months to 6 months)181 days to 365+ days (+6 months to 1 year)
Were you employed at a previous job (since July of 2023) ?*

YesNo
Name of Previous Employer*
How long were employed at your previous job?*

0-30 days (0-1 month)31-90 days (+1 month to 3 months)91-180 days (+3 months to 6 months)181 days to 365+ days (+6 months to 1 year)
Do you currently receive pay stubs (taxes are taken out), or are you paid in cash/private check?*

Pay stubsCash/Cashapp/Zelle/Venmo/otherCheck from owner
At your previous job, did you receive pay stubs (taxes were taken out), or were you paid in cash/cashapp or private check from owner?*

Pay stubs (for W2 employment- taxes are withheld)Cash/Cashapp/Zelle/Venmo/other (taxes are not withheld)Check from owner (taxes are not withheld)
(REQUIRED) Upload your most recent pay stub(s) for W2 employment *

Cancelof
(REQUIRED) Upload your most recent screenshot of a deposit, cash payment, or private check ry *

Cancelof
I affirm that the information I have submitted above is true and accurate. SIGN HERE:*

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JumpStart Pay Stub and Payment Statements