Request For Payment Of Wages Other Than Weekly - State Of New Hampshire printable pdf download

Request For Payment Of Wages Other Than Weekly - State Of New Hampshire

STATE OF NEW HAMPSHIRE

DEPARTMENT OF LABOR

REQUEST FOR PAYMENT OF WAGES OTHER THAN WEEKLY

COMPANY NAME:______________________________________________________

ADDRESS:_____________________________________________________________

TELEPHONE NUMBER:__________________________________________________

CONTACT PERSON:_____________________________________________________

FEDERAL ID NUMBER:__________________________________________________

NUMBER AND CLASSIFICATION EMPLOYEES: Salary:______

Hourly:______

METHOD OF PAYMENT: Bank Check__________ Cash_________

Direct Deposit________ Electronic Funds Transfer______

FREQUENCY OF PAYMENT: Biweekly_____; Semi- Monthly_____; Monthly______;

SALARY RANGE (LOWEST TO HIGHEST) _________________________________

DAY OF THE WEEK PAY PERIOD BEGINS__________________________________

DAY OF THE WEEK PAY PERIOD ENDS____________________________________

DESIGNATED PAY DAY__________________________________________________

DETAILED REASON FOR REQUEST_______________________________________

________________________________________________________________________

Please send to:

Cynthia Flynn

Wage & Hour Administrator

New Hampshire Department of Labor

PO Box 2076

Concord, NH 03302-2076

Request For Payment Of Wages Other Than Weekly - State Of New Hampshire