Pick-Up Authorization Form

Pick-Up Authorization Form

This form must be submitted by the Primary Contact
Date

MonthDayYear
Date
Company Number*
Company Name*
Primary Contact submitting this form*
Primary Contact Email*
example@example.com
As an added measure of security and confidentiality, Asure will require clients to sign for their payrolls when they pick them up.

Below, please supply Asure with a current list of authorized personnel who will be picking up your payroll. If someone other than the people listed below is going to pick up your payroll, please email your Payroll Specialist in advance, so that we will be expecting them. This person will be be required to show a form of identification.

Thank you for your cooperation.
Name
Name
Name
Name
Name
Signature*

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