Contract Worker Information Sheet printable pdf download

Contract Worker Information Sheet

Company Name ________________________________________________________________

1099/ Contract Worker Information Sheet

New Hire,

Change,

Re-hire,

Termination

Individual Information

Social Security Number _________________________________ Employee # _____________

Name: Last__________________________First:___________________________MI__________

Address: ________________________________________________________________________

City: ________________________________________State: ___________ZIP: ______________

Birth Date: ____/____/______ Gender: ___________

Or Company Information

Employer Identification Number: ______________________________ Company Code:_________

Address: ________________________________________________________________________

City: _________________________________________State: __________Zip: ________________

Telephone: _________________________

Department: _______________

Hire Date: ____/____/______ Re-hire Date: _____/____/_____ Term Date: ____/____/_____

Pay Rate Information

Weekly,

Bi-Weekly,

Semi-Monthly,

Monthly

Pay Frequency:

Hourly Rate1: $_____________

Salary: $___________________per Pay Period **

Rate2: $_____________

Pay Overtime:

Yes

No (If Salaried)

First Pay Amount if Prorated: $_______________________

If rate is based on something other than hours, please specify. ______________________________

Direct Deposit Information

Bank T/R #: __________________________Account Number _________________________________

(6 character)

Email address ________________________________________password_______________________

Account Type: checking savings

(circle one)

(f:\documents\new client docs\1099 Contract Worker Information Sheet.doc)

Contract Worker Information Sheet