Employee Information Sheet
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1Company Name ________________________________________________________________
Employee Information Sheet
New Hire,
Change,
Re-hire,
Termination,
1099/Contractor
Social Security Number _________________________________ Employee # _______________
Name: Last__________________________First:___________________________MI__________
Address: ______________________________________________________________________
City: ________________________________________State: ___________ZIP: ______________
Telephone #: ______________________ Birth Date: ________________ Gender: ____________
Department: _______________ Status:
Full Time,
Part time,
Other ___________________
Hire Date: ________________ Re-hire Date: ________________ Term Date: ________________
Pay Rate Information
Pay Frequency:
Weekly,
Bi-Weekly,
Semi-Monthly,
Monthly
Hourly Rate1: $_____________
Salary: $___________________per Pay Period **
Rate2: $_____________
Pay Overtime:
Yes
No (If Salaried)
First Pay Amount if Prorated: $_______________________
Tax Information
______
Single,
Married,
Married w/h at Single Rate; Number of Allowances
W-4 Filing Status:
______
Single,
Married,
Married w/h at Single Rate; Number of Allowances
State:
Extra Taxes Withheld ($/ %) Fed ________________ State ________________
Deduction Information
Deduction ___________________ Amount ________________
_______
per __________________
Deduction __________________ Amount __________
_
_____________
per _______
___________
Notes _________________________________________________________________
______________________________________________________________________
______________________________________________________________________
(P:\documents\new hire setup.doc)
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Parent category: Business