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Other forms that you may need are listed below. Please contact us if you're not able to find something here that you need.

General use forms


Intake Form
File Size: 45 kb
File Type: docx
Download File

Client Copy of Policy and Procedures
File Size: 24 kb
File Type: docx
Download File


The 787 form is for those who have never had a payee before. If SSA is mandating someone HAS to have a payee, this form (787) is not needed.
Authorization to Release Information
File Size: 443 kb
File Type: pdf
Download File

787 Form
File Size: 1044 kb
File Type: docx
Download File


PayCo - 895 South High Street - Columbus, Oh 43206  
Call  614-297-6420    Fax  614-737-0518


PayCo Dayton - 10 N. Williams St - Dayton, OH  45402
Phone: 
937-949-7470​  Fax: 937-949-7471
Call 1-844-447-2926 or​ 1-844-44-PayCo
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 Site last updated: May 13th 2019