This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Hmong. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 11-055?
A: DSHS Form 11-055 is the Acknowledgement of My Responsibilities as the Employer of My Individual Providers form.
Q: Who is the document intended for?
A: The document is intended for individuals who are employing individual providers in Washington.
Q: What is the purpose of this form?
A: The purpose of this form is to acknowledge and understand the responsibilities of being an employer of individual providers.
Q: What language is this form in?
A: This form is in the Hmong language.
Form Details:
Download a printable version of DSHS Form 11-055 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.