Payroll Service Request

Payroll Service Checklist

Employer Information
Business Name*
Contact Name*
Address*

Business Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Phone*
Filing Name (if different)
Email*
example@example.com
Filing Address (if different)
City, State, Zip
Company Type*

S-CorpC-CorpLLCLLPPartnershipSole Proprietor501(c)3Other
Direct Deposit

This section is needed in order to setup direct deposit and payroll tax filings.
Employer Bank Routing Number*
Employer Bank Account Number*
Principal Officer's Full Name*
Principal's Social Security will also be needed and received another way.
Principal's Date Of Birth*

MonthDayYear
Date
Federal law requires that we store and verify information about the principal officer. The principal officer is the person who is the main contact for the bank account from which electronic payments (including direct deposit) are made. Any errors or omissions will delay e-file and e-pay enrollment.
Number of W-2 employees*
Federal Deposit Schedule

MonthlySemi-WeeklyOther
Number of 1099-NEC contractors to be paid through payroll*
First Date To Run Payroll*

MonthDayYear
Date
Federal EIN*
State Employer Account Number*
State Unemployment Account #
State Deposit Schedule Only applicable to states with income tax*

Same as federalOther
Payroll History
Attach any historical payroll information from this calendar year for all active and terminated employees

Have not run any payroll yet this year
Beginning of Calendar Quarter Start. If you will begin using our service at the start of the 2nd, 3rd or 4th calendar quarter (April 1, July 1, or October 1), please include the following items.

Year-to-date wages, taxes, and deductions for each employeeDates and amounts of all payroll tax payments made to date for current year tax liabilities
Middle of Calendar Quarter Start. If you will begin using our service in the middle of a calendar quarter, please include the following items.

Year-to-date wages, taxes, and deductions for each employee as of the most recent payrollYear-to-date wages, taxes, and deductions for each employee as of the end of the most recentPayroll register or other summary for each payroll date in the current quarter, including totalDates and amounts of all payroll tax payments made to date for current year tax liabilities
Notes
Should be Empty:

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Payroll Service Checklist

Direct Deposit

Payroll History