New View staffing App

Date/Fecha

MonthDayYear
Date
Last /Apellido:
Social Sec. Num:
First/Primer:
Address/Domicilio
DOB/Fecha de Nacimiento:
Emergency Contact Name and Phone Number/Contacto de Emergencia Nombre y Numero De Telefono:
Phone/Telefono:
Company/Compania:
Position/Posicion:
Dates Employed/Fechas Trabajadas:

MonthDayYear
Date
Month/Mes
Supervisor:
Duties responsible for/Deberes responsable:
Address/Domicilio:
Reason for leaving/Razon por irse:
Year/Ano
to/a
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Date

MonthDayYear
Date
(a) First name and middle initial/ Primer Nombre
Last name/Apellido
(b) Social security number/ Seguro Social
Address/Domicilio
City or town, state, and ZIP code/ Cuidad, Estado, Codigo Postal
Single or Married filing separatelyMarried filing jointly (or Qualifying widow(er))Head of household (Check only if you're unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying
(c) If there are only two jobs total, you may check this box. Do the same on Form W 4 for the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld
Multiply the number of qualifying children under age 17 by $2,000/ Multiplique numero de dependes menores de 17 anos por $2,000
Multiply the number of other dependents by $500/ Multiplique numero de otros dependes por $500
Add the amounts above and enter the total here 3/ Sume los totales de arriba y ponga el total de la cantidad aqui
(a) Other income (not from jobs). If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income 4(a)
(b) Deductions. If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here 4(b)
(c) Extra withholding. Enter any additional tax you want withheld each pay period
Employee's signature (This form is not valid unless you sign it.)/ Firma

Clear
Date/Fecha

MonthDayYear
Date
Last Name/ Apellido
First Name/Primer Nombre
Middle Initial
Address/Domicilio
Apt. Number/Numero de Apt.
City/Cuidad
State/Estado
Zip Code/ Codigo Postal
Date of Birth (mm/dd/yyyy)/ Fecha De Nacimiento

MonthDayYear
Date
U.S. Social Security Number/Numero de Seguro Social
Employee's E mail Address/ Correo Electronico
example@example.com
Employee's Telephone Number/Numero de Telefono
1. A citizen of the United States2. A noncitizen national of the United States (See instructions)3. A lawful permanent resident (Alien Registration Number/USCIS Number):
An alien authorized to work until (expiration date, if applicable, mm/dd/yyyy):

MonthDayYear
Date
1. Alien Registration Number/USCIS Number:
2. Form I 94 Admission Number:
Foreign Passport Number:
Country of Issuance:
Signature of Employee/Firma

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Today's Date (mm/dd/yyyy)/ Fecha de hoy

MonthDayYear
Date
Signature of Preparer or Translator

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Expires
First Name (Given Name)
M.I.
Citizenship/Immigration Status
Issuing Authority
Expiration Date (if any) (mm/dd/yyyy)

MonthDayYear
Date
Additional Information
The employee's first day of employment (mm/dd/yyyy):
Today's Date (mm/dd/yyyy)

MonthDayYear
Date
Title of Employer or Authorized Representative
Name

First Name of Employer or Authorized RepresentativeLast Name of Employer or Authorized Representative
Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name)
City or Town
State
ZIP Code
Last Name (Family Name)
Middle Initial
Date (mm/dd/yyyy)

MonthDayYear
Date
Document Title
Document Number
Signature of Employer or Authorized Representative

Clear
Name of Employer or Authorized Representative