Payroll Form - Fillable
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1Payroll Form
To enable us to pay out your wages effectively we will need you to fill in the following
information:
Full name: ______________________________________________
Social security number: ____________________________________________
Employee number: __________________________________________
Date of employment: ______________________________ Year: _________________
Union name (specify only if you have joined a worker’s union): _________________________
Department: ________________________________________
Which period would you like to receive your wages?
ST
th
1
payroll of month (16
–end of month pay period) ___________________________
ND
st
th
2
payroll of month (1
-16
pay period) ________________________________________
How would you prefer to receive your wages?
Cash payment _____________________________________
Check payment ___________________________________
Signed: _________________________________
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Sample Form
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Parent category: Business