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Information for Providers

Regulated Provider Packet

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See below to download the Regulated Provider Packet

Page 1 of 7 - Regulated Provider Packet Memo
Page 2 of 7 - Provider Financial Agreement
Page 3 of 7 - Instructions for Financial Agreement
Page 4 of 7 - Assignment of Authorized Representative Agreement
Page 5 of 7 - Instructions for Assignment of Authorized Representative
Page 6 of 7 - Direct Deposit Agreement
Page 7 of 7 - W-9 Form

                                        Workforce Solutions Northeast Texas is an Equal Opportunity Employer/Program.
                                        Auxiliary aids and services are available upon request to individuals with disabilities.
                                        Relay Texas: TDD (800) 735.2989 Voice: (800) 735.2988