401(K) New Hire Form

ASI

Pension Administration

401(K) NEW HIRE FORM

This form should be completed on every new employee regardless of age or

whether they hold a part time or full time position.

COMPANY NAME: _______________________________

EMPLOYEE NAME: _______________________________

SOCIAL SECURITY # ____________________________

ADDRESS: ______________________________________

______________________________________

DATE OF BIRTH: ___________________________

DATE OF HIRE: ___________________________

HOURLY RATE: ____________________

SALARY RATE:

____________________

Administration Specialists, Inc.

PHONE: 1-800-228-3544

6370 Normandy St.

FAX:

(989) 799-3692

Saginaw, Michigan 48638

E-MAIL:

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Parent category: Business