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DSHS 14-438, Stop Work, page 1
Moderate · 61/100Form Complexity Index

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What this form asks for

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Form DSHS 14-438, also known as the Stop Work form, is a document used by the Washington State Department of Social and Health Services to confirm that a client's employment has ended. It requires the client's permission and detailed information from the former employer regarding the last day of work, final paychecks, and the reason for termination to accurately assess eligibility for benefits. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
Fillable fields61
Pages1
Sections18
Tables and lists1
Questions that depend on earlier answers9
Form Complexity IndexModerate, 61/100

The AI checks your answers before you download

14 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Ensures Final Paycheck Date is Logically Sound

This validation checks that the 'Date received' for the final paycheck is on or after the 'Last date that the employee worked'. An employee cannot receive their final paycheck before their last day of work. This check prevents logical inconsistencies in the timeline of events, which is critical for determining eligibility periods. If the date is earlier, the form should be flagged for manual review or rejected.

Conditional Requirement for 'On Leave' Details

If the 'On leave' checkbox is selected as the reason the job ended, this validation ensures that a subsequent choice ('Paid' or 'Unpaid') is also selected and that the 'Expected return date' is provided. This is important because leave status directly impacts benefit calculations and eligibility. A failure to provide these details results in an incomplete submission that cannot be processed correctly.

Conditional Requirement for 'Paid Leave' Amount

This check verifies that if the 'On leave' and 'Paid' options are both selected, the 'how much is the employee paid' field must contain a valid, positive currency amount. This income information is essential for DSHS to accurately assess the client's financial situation. An empty or invalid amount would require follow-up and delay case processing.

Conditional Completion of Severance Pay Information

If the 'yes' option is selected for 'Will the employee receive any severance pay?', this validation ensures that both the 'When will it be received?' date and the 'How much will it be?' amount fields are filled out. Severance pay is a key financial resource that must be accounted for. Incomplete information would prevent a full assessment of the client's income.

Conditional Completion of Vacation/Sick Pay Information

This validation confirms that if 'yes' is selected for 'Can the employee cash out vacation/sick pay?', the corresponding 'When will it be received?' and 'How much will it be?' fields are completed. This information is crucial for understanding lump-sum payments that affect benefit eligibility. Failure to provide these details makes the section incomplete and requires correction.

Mandatory Explanation for 'Other' Job End Reason

This check ensures that if the 'Other' checkbox is selected for 'Why did this job end?', the adjacent text field must contain an explanation. An 'Other' selection without context is ambiguous and unusable for determination purposes. This validation forces the employer to provide the necessary details for DSHS to understand the circumstances of the job separation.

And 8 more checks
  • Completeness of Employer Contact and Signature
  • Validation of All Date Formats
  • Validation of All Currency Field Formats
  • Client Authorization Completeness in Section 1
  • Logical Sequence of Signature Dates
  • Consistency of 'Other Paychecks' Month
  • Prevention of Future Dates for Past Events
  • Mutual Exclusivity of Job End Reasons

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How to Fill Out DSHS 14-438 Online for Free in 2026

What the AI walks you through.

  1. Navigate to Instafill.ai and upload or select the DSHS 14-438 Stop Work form.
  2. As the client, use the AI assistant to fill in your name and sign Section 1, granting your former employer permission to complete the form.
  3. Securely share the form with your former employer to complete their section.
  4. The employer then fills out Section 2, providing details on the last day worked, final paycheck amounts and dates, and the reason for employment termination.
  5. The employer adds their signature, date, and contact information to certify the provided details.
  6. Review all entered information across both sections for accuracy and completeness.
  7. Submit the finalized form directly to the DSHS mailing address or fax number provided on the document.

Common Mistakes in Completing DSHS 14-438

The ones the AI is built to catch.

Missing or Incorrect Case / Client ID Number
Clients often forget to enter their Case or Client ID number at the top of the form. This number is the primary identifier DSHS uses to link the document to the correct benefits case. Without it, the form cannot be processed, leading to significant delays or rejection. To avoid this, locate the ID on previous letters or documents from DSHS and carefully transcribe it in the designated field.
Client Forgets to Sign and Date Section 1
The client's signature in Section 1 is a legal authorization for the employer to release confidential payroll information. Forgetting to sign and date this section before giving it to the employer means the employer may legally refuse to complete the form. This halts the entire process until the client can provide a signed copy. Always sign and date Section 1 before it leaves your hands.
Reporting Net Pay Instead of Gross Pay
Employers completing Section 2 frequently enter the employee's net (take-home) pay instead of the gross amount (before taxes), as explicitly requested. DSHS benefit calculations are based on gross income, so this error leads to incorrect eligibility assessments and potential under or overpayment of benefits. Always refer to the 'gross pay' line on the employee's pay stub to ensure accuracy.
Incomplete Answers for Conditional Questions
In Section 2, questions about severance, vacation pay, and retirement funds require follow-up information (amount and date) if the answer is 'Yes'. A common mistake is checking 'Yes' but leaving the amount and date fields blank. This creates incomplete data, forcing DSHS to contact the employer for clarification and delaying the client's case. If you check 'Yes', you must fill in all associated details.
Confusing Pay Period End Date with Paycheck Received Date
When listing paycheck information, employers sometimes enter the date the pay period ended rather than the date the employee actually received the payment. DSHS needs the exact date the income was received to determine eligibility for a specific time frame. The correct date is the check date or the direct deposit date, not the last day of work covered by that pay.
Using an Informal or Incorrect Employer Name
Clients may write a common name for their workplace (e.g., 'The Corner Deli') instead of the official legal business name found on pay stubs or W-2 forms. This can make it difficult for DSHS to verify the employment information with state records. To prevent verification issues, always use the full, legal name of the company.
Vague or Unspecified Reason for Job Ending
When the reason for job termination doesn't fit the standard checkboxes, employers may check 'Other' but fail to provide a clear, concise explanation. A vague entry like 'personal reasons' is insufficient for DSHS to determine eligibility. This requires follow-up and can delay a decision. If 'Other' is selected, provide a brief but specific explanation for the separation.
Employer Forgets to Sign and Provide Contact Information
The signature, printed name, title, and phone number of the employer representative in Section 2 are crucial for validating the form's authenticity. Omitting this information renders the document incomplete and unverifiable, and prevents DSHS from contacting the employer with questions. The person filling out Section 2 must complete all fields in the final contact block.
Incorrect Person Completing the Employer Section
The form is sometimes given to a direct supervisor or front-desk employee who doesn't have access to official payroll records. This can lead to guesswork and inaccurate financial data regarding final pay, vacation payouts, and severance. To ensure accuracy, the form should be directed to the Human Resources (HR) or Payroll department, as they have direct access to the required information.
Leaving Date Fields in an Ambiguous Format
Both clients and employers may write dates in non-standard formats like '4/5' or 'Feb 2024', which can be ambiguous (is it April 5th or May 4th?). This ambiguity can cause errors in processing. Always use a clear, full format like MM/DD/YYYY (e.g., 04/05/2024) to avoid misinterpretation. AI-powered tools like Instafill.ai can help by automatically standardizing date formats to prevent this error.

Frequently Asked Questions About DSHS 14-438

 

Is it really free for 7 days?
Yes. You pay $0 today. Cancel before Nov 1 and you are never charged. Keep it, and it is $19.99 a month for 5 fills of your DSHS 14-438.
Can I fill other forms too?
This plan is for your DSHS 14-438: your own AI agent fills it as often as 5 times a month. To fill other forms and upload your own, choose a Professional plan from your account.
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From your account, in two clicks, any time. No email, no call.
How does the AI fill out DSHS 14-438?
You answer a few questions in plain words, or upload a document you already have. The AI reads what you give it and puts each answer into the right field of DSHS 14-438, on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is DSHS 14-438 to fill out?
DSHS 14-438 has a Form Complexity Index of 61 out of 100, in the moderate tier: 61 fillable fields across 1 page. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of the DSHS 14-438 Stop Work form?
This form is used by the Department of Social and Health Services (DSHS) to verify that a client's employment has ended and to gather details about their final pay. This information helps DSHS determine a client's ongoing eligibility for benefits.
Who needs to fill out this form?
The form is completed in two parts. The client (the person whose job ended) must fill out and sign Section 1, and their former employer is responsible for completing all the employment and pay details in Section 2.
As the client, what do I need to do in Section 1?
In Section 1, you must print your name, provide your Case/Client ID number, and sign and date the form. This gives your former employer permission to release your employment information to DSHS.
I'm an employer. What information is required in Section 2?
You need to provide the employee's last day of work, the gross amount and date of their final paycheck, and the reason the job ended. You must also report any upcoming severance, vacation/sick pay cash-outs, or retirement fund withdrawals.
What does 'Amount before taxes' mean for the paycheck information?
This refers to the gross pay, which is the total amount of earnings before any deductions like taxes, Social Security, or insurance premiums are taken out. You should report the full, pre-tax amount.
Where do I send the completed Stop Work form?
The completed form should be mailed to DSHS at PO BOX 11699, TACOMA, WA 98411-9905. Alternatively, you can fax it to the number provided on the form, 888-338-7410.
Where can I find my Case / Client ID Number?
Your Case or Client ID number is assigned by DSHS and can be found on other letters or notices you have received from them. If you cannot locate it, you may need to contact DSHS directly for assistance.
What if I am on leave from my job, not permanently separated?
Your employer should check the 'On leave' box in Section 2, question 3. They will then need to specify if the leave is paid or unpaid and provide your expected return-to-work date.
My employer hasn't paid me my final check yet. How should they fill out the form?
Your employer should still enter the amount of the final paycheck and the date you are scheduled to receive it. This information is necessary for DSHS to accurately assess your income.
Can I use an AI tool to help me fill out this form?
Yes, services like Instafill.ai use AI to auto-fill form fields accurately and save time. This can help ensure your information is entered correctly and reduce the time it takes to complete the form.
How can I fill out the DSHS 14-438 form online?
You can use a service like Instafill.ai to fill out the form online. Simply upload the form to the platform, and its AI will make the fields interactive so you can type your information, review it, and then download the completed PDF.
The PDF copy of the form I have is not fillable. What should I do?
If you have a non-fillable PDF, you can use a tool like Instafill.ai to make it interactive. The service converts flat PDFs into fillable forms, allowing you to easily type your information into the correct fields.
What is considered 'severance pay' on this form?
Severance pay is compensation an employee receives when their job ends involuntarily. If your employer is providing a severance package, they must report the amount and the date you will receive it in Section 2.
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