Employee Information Sheet
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2EMPLOYEE INFORMATION SHEET
Complete this form for each employee.
Personal Information
Employee Name __________________________________
Birth Date
MM____/DD____/YY____
Address
__________________________________
Hire Date
MM____/DD____/YY____
City, State, Zip
__________________________________
Social Security No. __________________
Email Address
__________________________________
Gender
Female
Male
Direct Deposit Information
Will this employee be paid by direct deposit?
Yes. If so, please complete the Authorization of Direct Deposit form
No
Tax Information
Please attach or specify the following information for this employee:
Attach completed federal Form W-4
Attach completed state withholding form. Only applicable if state income tax and filing
status/allowances are different from federal
Specify any payroll taxes that this employee is exempt from, such as state unemployment, social
security, or Medicare:
_________________________________________________________________________________
Specify any local taxes that need to be withheld from this employee’s paycheck:
_________________________________________________________________________________
Notes:
Pay Information
Which types of pay does this employee receive?
Salary $______ per ____
Overtime Pay
Clergy Housing (Cash)
Double Overtime
Clergy Housing (In-Kind)
Hourly Rates (up to 8 different)
Sick Pay
Bereavement Pay
$_____ / hour
Holiday Pay
Group Term Life Insurance
$_____ / hour
Vacation Pay
S-Corp Owners Health Ins.
$_____ / hour
Bonus
Personal Use of Company Car
$_____ / hour
Commission
Other: __________________
$_____ / hour
Allowance
$_____ / hour
Reimbursement
$_____ / hour
Cash Tips
$_____ / hour
Paycheck Tips
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Parent category: Business