Instructions For Filling Out The I-9 Form, The W-4 And The Ct W-4 Template Page 2
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1
2Personnel Forms Instructions
Each new and returning employee must fill out completely (in ink).
1. Town of Fairfield Application (must have a new one on file each year)
2. W-4 Form
3. CT W-4
4. I-9
5. Social Security Statement
6. Premiere Advantage Retirement Savings Plan (New Employees Only) NOT OPTIONAL
SUPERVISOR: See helpful tips on back of this page for filling out I-9, W-4 and CT W-4.
The hiring supervisor must examine the supporting documents from the I-9 Form and sign where asked. Supervisor should also
check both W - 4 forms to make sure they were done correctly.
Please PHOTO COPY all forms as well as supporting documents (Social Security Card, License or Passport) and send originals
to The Fairfield Parks & Recreation Department at least one day prior to start date and prior to submitting payroll hours.
Supervisor, please complete the following:
1. Employee’s Name: __________________________________________ Phone Number:_____________________
2. Start Date: _________________________________________________
3. Rate of Pay - $_______________________________________________
4. Payroll Account: (Check One)
Rate
_____ Penfield Custodian/Keygirl 01007030 51070 _______ Pay Type 110
_____ Penfield Party Att.
01007030 51070 _______ Pay Type 838
_____ Recreation
01007050 51070
_____ Recreation TRUST
12407050 51030 Project ______0 See Below for Job Class Code Circled
_____ Recreation Youth Grant
12507050 51020
_____ Beaches and Lifeguards
01007070 51070
See below For Job Class Codes Circled
_____ Parks – Beach Stickers
01007070 51070
_____ H.S.R. Clubhouse/Range
01007113 51070 20000 See below for Job Class Codes circled
_____ H.S.R. Maintenance
01007113 51070
_____ PAR 3
01007111 51070
See Below for Job Class Codes circled
_____ PAR 3 Maintenance
01007111 51070
POSITION: _______________________
5.
JOB CLASS CODES
ADD TO PAYROLL GROUP
GOLF
OTHER
_________________________
TS16 Pro Shop Cashier TS18 Rec. Program Director
TS12 Starter
TS20 Rec. Program Asst. Dir.
TS10 Ranger
TS22 Rec. Program Staff
TS14 Carts
TS24 Rec. Program Attendant
TS17 Range Cashier
TS54 Picker
TS42 Maintenance
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