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Caregiver pay agreement template

A plain-language written agreement for a family and the in-home caregiver they hire to help an aging parent. Fill it in, print it, and each keep a signed copy — so you're both clear on pay, hours, duties, and time off from day one.

  1. 1.Fill in the blanks on screen, or print it blank and write them in by hand.
  2. 2.Talk it through together and adjust anything that doesn't fit your arrangement.
  3. 3.Print two copies, sign and date both, and each keep one.

This template is a starting point, not legal advice, and not a substitute for an attorney. Employment, tax, and benefit rules vary by state and by situation — review your agreement with a qualified attorney or elder-law professional before you rely on it.

Caregiver Pay Agreement

This agreement records the terms between the household employer and the in-home caregiver named below. It is meant to be adapted to your situation.

1. The people

Who is employing whom. The household employer is usually the aging parent receiving care, or the family member managing their household.

2. The job

The role and what it involves. Be as specific as helps you both.

3. Schedule & hours

When, and how much. Overtime and minimum-wage rules vary by state.

4. Pay

Rate, schedule, and method. These are your own figures — agree on them together; this template doesn't set a rate.

5. Time off & expenses

Paid time off, holidays, and what the family covers.

6. Tracking hours

7. Ending the arrangement

How either side can end it, and how the final pay is handled.

8. Additional terms

Signatures

Sign and date two copies — one for the family, one for the caregiver.

Household employer (family)

Signature
Print name
Date

In-home caregiver

Signature
Print name
Date

About taxes: when a household worker's cash wages for the year reach $3,000, a family generally owes Social Security and Medicare taxes as a household employer, and withholding may apply. Whether and how much applies depends on your situation — confirm with a tax advisor. KinPayroll can run the payroll and year-end forms once you've agreed on pay.

This template is a starting point, not legal advice, and not a substitute for an attorney. Employment, tax, and benefit rules vary by state and by situation — review your agreement with a qualified attorney or elder-law professional before you rely on it.

Agreed on the terms? Now pay them the right way.

Once you've settled pay and schedule, KinPayroll runs the payroll, handles Social Security and Medicare, and has the W-2 ready at year-end — so your written agreement is backed by clean records.

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Free accountNo credit cardW-2 at year-end