California - New Hire Packet

Instructions
This portal will guide you through the process of completing the following forms:
- Federal I-9
- Federal W4
- California DE4
- Direct Deposit Authorization
Documents that establish both identity and employment authorization will need to be uploaded in accordance with the I-9. A list of approved documents is noted below.
Local Union Name & Number*

Employment Eligibility Verification

USCIS Form I-9Department of Homeland Security
Employment Eligibility Verification Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-9

OMB No. 1615-0047

Expires 07/31/2026
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)
Name*

Last NameFirst NameMiddle Initial Other Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth*

MonthDayYear
Date
Social Security Number (numbers only)*
Email*
example@example.com
Phone Number*

Area CodePhone Number
I am aware that federal law provides for imprisonment and/or fines for false statements, or the use of false documents, in connection with the completion of this form. I attest, under penalty of perjury, that this information, including my selection of the box attesting to my citizenship or immigration status, is true and correct.*

1. Citizen of the United States2. A noncitizen national of the United States (see instructions)A lawful permanent residentA noncitizen
Enter USCIS Number or A-Number
If a noncitizen authorized to work please enter work expiration date.

MonthDayYear
Date
A noncitizen authorized to work must provide only one of the following document numbers to complete Form I-9: USCIS A-Number or I-94 admission number or foreign passport number and Country of Issuance.

1. USCIS A-NumberForm I-94 Admission NumberForeign Passport Number
Alien Registration Number/USCIS Number
Form I-94 Admission Number
Foreign Passport Number
Country of Issuance
Signature of employee*

Clear
Signature (Stylus or finger)
Today’s date*

MonthDayYear
Date
Preparer and/or Translator (Check one)*

I did not use a preparer or translatorI did use a preparer and/or translator
Preparer or translator signature

Clear
Date signed

MonthDayYear
Date
Name of preparer or translator

First NameLast Name
Address of preparer or translator

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload a Picture of your List A or B Document to validate your identification (See below for examples)*
Upload a Picture of your List C Document to validate your identification (See below for examples)

Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
CA Filing Status*

Single or Married (with two or more incomes)Married ( one income)Head of household
1. Use Worksheet A for Regular Withholding allowances. Use other worksheets on the following pages as applicable. 1a. Number of Regular Withholding Allowances (Worksheet A) Enter Allowances
1b. Number of allowances from the Estimated Deductions (Worksheet B, if applicable.) Amount you want witheld
1c. Total Number of Allowances you are claiming
Exemption from Withholding
2. Additional amount, if any, you want withheld each pay period (if employer agrees), (Worksheet C)
OR
3. I claim exemption from withholding for 2024, and I certify I meet both of the conditions for exemption.  (Check box here)
OR
4. I certify under penalty of perjury that I am not subject to California withholding. I meet the conditions set forth under the Service Member Civil Relief Act, as amended by the Military Spouses Residency Relief Act and the Veterans Benefits and Transition Act of 2018.    (Check box here)
Signature*

Clear
Date*

MonthDayYear
Date
PURPOSE: This certificate, DE 4, is for California Personal
Income Tax (PIT) withholding purposes only. The DE 4 is used to
compute the amount of taxes to be withheld from your wages,
by your employer, to accurately reflect your state tax withholding
obligation.
Beginning January 1, 2020, Employee’s Withholding Allowance
Certificate (Form W-4) from the Internal Revenue Service (IRS) will
be used for federal income tax withholding only. You must file the
state form Employee’s Withholding Allowance Certificate (DE 4)
to determine the appropriate California Personal Income Tax (PIT)
withholding.
If you do not provide your employer with a withholding certificate,
the employer must use Single with Zero withholding allowance.
CHECK YOUR WITHHOLDING: After your DE 4 takes effect,
compare the state income tax withheld with your estimated total
annual tax. For state withholding, use the worksheets on this form.
EXEMPTION FROM WITHHOLDING: If you wish to claim
exempt, complete the federal Form W-4 and the state DE 4. You
may claim exempt from withholding California income tax if you
meet both of the following conditions for exemption:
1. You did not owe any federal/state income tax last year, and
2. You do not expect to owe any federal/state income tax this
year. The exemption is good for one year.
If you continue to qualify for the exempt filing status, a new DE 4
designating EXEMPT must be submitted by February 15 each year
to continue your exemption. If you are not having federal/state
income tax withheld this year but expect to have a tax liability
next year, you are required to give your employer a new DE 4 by
December 1.
Member Service Civil Relief Act: Under this act, as provided by the
Military Spouses Residency Relief Act and the Veterans Benefits and
Transition Act of 2018, you may be exempt from California income
tax on your wages if
(i) your spouse is a member of the armed forces present in
California in compliance with military orders;
(ii) you are present in California solely to be with your spouse;
and
(iii) you maintain your domicile in another state.
If you claim exemption under this act, check the box on Line 4.
You may be required to provide proof of exemption upon request.
Do you want to view and fill out/view the CA DE-4 Worksheet for your records?

YesNo
WORKSHEETS
INSTRUCTIONS — 1 — ALLOWANCES*
When determining your withholding allowances, you must consider your
personal situation:
— Do you claim allowances for dependents or blindness?
— Will you itemize your deductions?
— Do you have more than one income coming into the household?
TWO-EARNERS/MULTIPLE INCOMES: When earnings are derived
from more than one source, under-withholding may occur. If you have a
working spouse or more than one job, it is best to check the box “SINGLE
or MARRIED (with two or more incomes).” Figure the total number of
allowances you are entitled to claim on all jobs using only one DE 4 form.
Claim allowances with one employer.
Do not claim the same allowances with more than one employer. Your
withholding will usually be most accurate when all allowances are claimed
on the DE 4 filed for the highest paying job and zero allowances are
claimed for the others.
MARRIED BUT NOT LIVING WITH YOUR SPOUSE: You may check the
“Head of Household” marital status box if you meet all of the following
tests:
(1) Your spouse will not live with you at any time during the year;
(2) You will furnish over half of the cost of maintaining a home for the
entire year for yourself and your child or stepchild who qualifies as
your dependent; and
(3) You will file a separate return for the year.
HEAD OF HOUSEHOLD: To qualify, you must be unmarried or legally
separated from your spouse and pay more than 50% of the costs of
maintaining a home for the entire year for yourself and your dependent(s)
or other qualifying individuals. Cost of maintaining the home includes such
items as rent, property insurance, property taxes, mortgage interest, repairs,
utilities, and cost of food. It does not include the individual’s personal
expenses or any amount which represents value
(A) Allowance for yourself — enter 1 Enter 1
(B) Allowance for your spouse (if not separately claimed by your spouse) — enter 1 Enter 1 if applicable
(C) Allowance for blindness — yourself — enter 1  Enter 1 if applicable
(D) Allowance for blindness — your spouse (if not separately claimed by your spouse) — enter 1   Enter 1 if applicable
(E) Allowance(s) for dependent(s) — do not include yourself or your spouse   Enter # if applicable
(F) Total — add lines (A) through (E) above and enter on line 1 of the DE 4   Enter 1 if applicable
INSTRUCTIONS — 2 — (OPTIONAL) ADDITIONAL WITHHOLDING ALLOWANCES
If you expect to itemize deductions on your California income tax return, you can claim additional withholding allowances. Use Worksheet B to determine
whether your expected estimated deductions may entitle you to claim one or more additional withholding allowances. Use last year’s FTB Form 540 as a
model to calculate this year’s withholding amounts.
Do not include deferred compensation, qualified pension payments, or flexible benefits, etc., that are deducted from your gross pay but are not taxed on this
worksheet.
You may reduce the amount of tax withheld from your wages by claiming one additional withholding allowance for each $1,000, or fraction of $1,000, by
which you expect your estimated deductions for the year to exceed your allowable standard deduction.
WORKSHEET B ESTIMATED DEDUCTIONS
Use this worksheet only if you plan to itemize deductions, claim certain adjustments to income, or have a large amount of nonwage income not subject to
withholding.
1. Enter an estimate of your itemized deductions for California taxes for this tax year as listed in the schedules in the FTB Form 540   Estimated Deduction
2. Enter $9,606 if married filing joint with two or more allowances, unmarried head of household, or qualifying widow(er) with dependent(s) or $4,803 if single or married filing separately, dual income married, or married with multiple employers Allowances
3. Subtract line 2 from line 1, enter difference   Number
4. Enter an estimate of your adjustments to income (alimony payments, IRA deposits)   Adjusted Income
5. Add line 4 to line 3, enter sum
6. Enter an estimate of your nonwage income (dividends, interest income, alimony receipts)   Nonwage Income
7. If line 5 is greater than line 6 (if less, see below [go to line 9]); Subtract line 6 from line 5, enter difference   Line 6 - Line5
8. Divide the amount on line 7 by $1,000, round any fraction to the nearest whole number
Add this number to Line F of Worksheet A and enter it on line 1 of the DE 4. Complete Worksheet C, if needed, otherwise stop here.   Line7 / 1000$
9. If line 6 is greater than line 5; Enter amount from line 6 (nonwage income)   Line 6
10. Enter amount from line 5 (deductions)   Line 5
11. Subtract line 10 from line 9, enter difference   Line 9 - Line 10
*Wages paid to registered domestic partners will be treated the same for state income tax purposes as wages paid to spouses for California PIT withholding and PIT wages. This law does not impact federal income tax law. A registered domestic partner means an individual partner in a domestic partner relationship within the meaning of section 297 of the Family Code. For more information, please call our Taxpayer Assistance Center at 1-888-745-3886.
WORKSHEET C ADDITIONAL TAX WITHHOLDING AND ESTIMATED TAX
1. Enter estimate of total wages for tax year 2022.
2. Enter estimate of nonwage income (line 6 of Worksheet B).
3. Add line 1 and line 2. Enter sum.
4. Enter itemized deductions or standard deduction (line 1 or 2 of Worksheet B, whichever is largest).
5. Enter adjustments to income (line 4 of Worksheet B).
6. Add line 4 and line 5. Enter sum.
7. Subtract line 6 from line 3. Enter difference.
8. Figure your tax liability for the amount on line 7 by using the 2022 tax rate schedules below.
9. Enter personal exemptions (line F of Worksheet A x $141.90).
10. Subtract line 9 from line 8. Enter difference.
11. Enter any tax credits. (See FTB Form 540).
12. Subtract line 11 from line 10. Enter difference. This is your total tax liability.
13. Calculate the tax withheld and estimated to be withheld during 2022. Contact your employer to request the amount that will be withheld on your wages based on the marital status and number of withholding allowances you will claim for 2022. Multiply the estimated amount to be withheld by the number of pay periods left in the year. Add the total to the amount already withheld for 2022.
14. Subtract line 13 from line 12. Enter difference. If this is less than zero, you do not need to have additional taxes withheld.
15. Divide line 14 by the number of pay periods remaining in the year. Enter this figure on line 2 of the DE 4.

NOTE: Your employer is not required to withhold the additional amount requested on line 2 of your DE 4. If your employer does not agree to withhold the additional amount, you may increase your withholdings as much as possible by using the “single” status with “zero” allowances. If the amount withheld still results in an underpayment of state income taxes, you may need to file quarterly estimates on Form 540-ES with the FTB to avoid a penalty

Would you like to complete the Direct Deposit Authorization Form?*

YesNo
Direct Deposit Authorization
I would like to:*

Begin direct depositCancel direct depositUpdate my direct deposit account information
Bank/ Institution Name:*
Routing Number:*
Confirm Routing Number:*
Both Routing Number fields must match.
Account Number:*
Confirm Account Number:*
Both Account Number fields must match.
Type of Account:*

CheckingSavings
I authorize Union Payroll Agency, Inc. to email an electronic copy of my paystub to the email address listed below:*

YesNo, I prefer to have my paystub mailed to my address.
Email*
example@example.com
I authorize Union Payroll Agency, Inc. (UPA) and the specified financial institution to deposit my net pay into my account each pay date. If funds to which I am not entitled are deposited into my account, I authorize UPA to direct the financial institution to return the funds to UPA. This authorization is to remain in effect until I have filed a new authorization form or until revoked by me in writing.

**I understand Direct Deposit will not take affect until the the next pay date which occurs 10 business days after this form is received by UPA.

Pay day is friday unless contractually obligated otherwise.

Incorrect information and missing information will delay the initial start date of your Direct Deposit.
Signature*

Clear
Date*

MonthDayYear
Should be Empty:

Instructions

Employment Eligibility Verification

Step 2(b) - Multiple Jobs Worksheet

WORKSHEET C ADDITIONAL TAX WITHHOLDING AND ESTIMATED TAX

Direct Deposit Authorization