Palace Staffing Employees Application

Palace Staffing Employees' Application
Name*

First NameLast Name
DOB*

MonthDayYear
Date
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Are you US citizen?*

YesNo
Are you authorized to work in US?*

YesNo
SSN*
Have you been convicted of a felony or major crime?*

YesNo
Please explain your crime:*
Are you under 18?*

YesNo
Could you get work permission?*

English Proficiency

Score your skills from 1 to 10
Speaking*
Writing*
Reading*
Understanding*

Experience
Company: blanks*
Job Title:blank*
Start Date:   Date*
End Date:   Date*
Address:   Street Address*      City*   State*   Zip*
Work description:   Type a label*
Pay rate:   *
Reason for leaving:   Type a label*
Reference phone number:   Type a label*
Company: blanks
Job Title:blank
Start Date:   Date
End Date:   Date
Address:   Street Address      City   State   Zip
Work description:   Type a label
Pay rate:
Reason for leaving:   Type a label
Reference phone number:   Type a label
Company: blanks
Job Title:blank
Start Date:   Date
End Date:   Date
Address:   Street Address      City   State   Zip
Work description:   Type a label
Pay rate:
Reason for leaving:   Type a label
Reference phone number:   Type a label

Education
University/College
Institute name:
Graduation year:   Date
Degree Obtained:   Type a label

High School
Institute name:
Graduation year:   Date
Degree Obtained:   Type a label

Commerce School
Institute name:
Graduation year:   Date
Degree Obtained:   Type a label

Employment Eligibility Verification
USCIS
Department of Homeland Security
Form I-9
U.S. Citizenship and Immigration Services

OMB No.1615-0047 Expires 07 /31/2026

START HERE: Employers must ensure the form instructions are available to employees when completing this form. Employers are liable for failing to comply with the requirements for completing this form. See below and the Instructions.

ANTI-DISCRIMINATION NOTICE: All employees can choose which acceptable documentation to present for Form I-9. Employers cannot ask employees for documentation to verify information in Section 1, or specify which acceptable documentation employees must present for Section 2 or Supplement B, Reverification and Rehire. Treating employees differently based on their citizenship, immigration status, or national origin may be illegal.

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*

First Name (Given Name)Middle Initial (if any)Last Name (Family Name)
Other Last Names Used (If any)
Address (Street Number and Name)*
Apt. Number (if any)
City or Town*
State*
ZIP Code*
Date of Birth (mm/dd/yyyy)*

MonthDayYear
Date
U.S. Social Security Number*
Employee's Email Address*
example@example.com
Employee's Telephone 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.
Check one of the following boxes to attest to your citizenship or immigration status See page 2 and 3 of the instructions*

1. A citizen of the United States2. A noncitizen national of the United States See Instructions3. A lawful permanent resident Enter USCIS or A-Number4. A noncitizen (other than Item Numbers 2. and 3. above)
3. A lawful permanent resident Enter USCIS or A-Number*
4. A noncitizen (other than Item Numbers 2. and 3. above) authorized to work until (exp. date, if any)*

MonthDayYear
Date
If you check Item Number 4., enter one of these:
USCIS A-Number
Form I-94 Admission Number
OR
Foreign Passport Number and Country of Issuance
OR
Signature*

Clear
Today's Date (mm/dd/yyyy)*

MonthDayYear
Date

Employee’s Withholding Certificate - W4 Form
Department of the Treasury Internal Revenue Service

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Give Form W-4 to your employer. Your withholding is subject to review by the IRS.
Step 1:
(a) First name and middle initial*
Last name*
(b) Social security number*
Address*
City or town, state, and ZIP code*
(c)*

Single or Married filing separatelyMarried filing jointly or Qualifying surviving spouseHead 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 individual)
If your total income will be $200,000 or less ($400,000 or less if married filing jointly):
Claim Dependent and Other Credits
Multiply the number of qualifying children under age 17 by $2,000
Multiply the number of other dependents by $500
Total Amount
Signature*

Clear
Today's date*

MonthDayYear
Date

Employee’s Withholding Allowance Certificate
Complete this form so that your employer can withhold the correct California state income tax from your paycheck.
Enter Personal Information
First, Middle, Last Name*
Social Security Number*
Address*
City*
State*
ZIP Code*
Filling 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)
What is the number of depends on that you have?*
Employee’s Signature*

Clear
Date*

MonthDayYear
Date

Non-Compete Agreement

You agree that, during the period of employment, you will not seek or accept direct employment with any business that may be considered a client of Palace Staffing in any way for a period of 6 months after your resignation.

Specifically, you may not directly work, own, lease, control, operate, engage, manage, provide services, consult, advise, or allow your name to be used by any company associated with or a client of Palace Staffing in any manner.
Signature*

Clear

Responsibilities and Guidelines
1. Timesheet Approval: You are responsible for signing all timesheets; otherwise, the hours worked on unsigned timesheets will not be considered for corresponding payment.
2. Recording Work Hours: It is your responsibility to input your clock-in and clock-out times; otherwise, the hours worked on unsigned timesheets will not be considered for corresponding payment.
3. Personal Timesheet Record: Maintain your own record of timesheets.
4. Advance Notice of Absence: If you are unable to work the next day, you must notify us 24 hours in advance of your absence, except in emergencies.
5. Uniform Requirement: You must report to your workplace in the required uniform, as outlined in Annex A and B attached to this document.
6. Employment Terms: Palace Staffing is not obligated to provide full-time or part-time employment.
Signature*

Clear

Image Authorization
I hereby, in accordance with the United States Federal Copyright Law, grant permission to Palace Staffing to use photographs or video recordings that include my image in campaigns, promotional materials, and any other supporting material deemed relevant for the dissemination and promotion of the company, distributed domestically or internationally through any means, whether print, electronic, or otherwise. Additionally, based on the law, I wish to express that this authorization is voluntary and entirely free of charge. Therefore, Palace Staffing is free to use, reproduce, transmit, rebroadcast, publicly display, create other derivative works from my image in promotional campaigns through any means, as well as the fixation of said image in projections, videos, graphics, texts, films, and all supplementary materials of promotions and campaigns, establishing that it will be used solely and exclusively for the stated purposes. I declare that I waive any right to inspect or approve the sequences of video recording or photography. I authorize the use of my image for as long as the company deems appropriate; however, this authorization may be revoked by written notice addressed to Palace Staffing at 175 Bernal Road, Suite 100-2, San Jose, CA, 95119, or via email at admin@palacestaffing.com.

I declare that I am of legal age, and if not, one of my parents or legal guardians has signed the Consent/Legal Release form included at the end of this document.

Image Authorization
Signature*

Clear

Annex A: Employee Code - Permitted Attire
Positions:
- Housekeeping
- Steward/ Dishwasher
- Cook
- Cook helper
- No visible tattoos or piercings (except for ear piercings).
- Hair should be tied back.
- Maintain general hygiene.
Equipment Required:
Cook o cook helper: Knife Set, Hair Protective Cap or Net, and Cut-Resistant Gloves.
Upper Body
Polo Shirt

No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).
Lower Body
Pants

No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).

No jeans, no leggings. No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).
Shoes
Non-Slip Shoes

No logos, they must be presentable.
Signature

Clear

Annex A: Employee Code - Permitted Attire
Positions
- Banquet Server/ waiters
- Bartender
- Barista
- Cashiers
- No visible tattoos or piercings (except for ear piercings).
- Hair should be tied back.
- Maintain general hygiene.
Upper Body
Shirt

No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).
Lower Body
Pants

No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).

No jeans, no leggings. No logos, stripes, or markings. It must be presentable (clean and/or ironed if necessary).
Shoes
Non-Slip Shoes

No logos, they must be presentable.
Signature

Clear
Should be Empty:

Palace Staffing Employees' Application

English Proficiency

Availability

Experience

Education

Employment Eligibility Verification

USCIS

Department of Homeland Security

Form I-9

USCIS A-Number

Form I-94 Admission Number

Foreign Passport Number and Country of Issuance

Employee’s Withholding Certificate - W4 Form

Step 1:

Claim Dependent and Other Credits

Employee’s Withholding Allowance Certificate

Enter Personal Information

Image Authorization

Positions:

Equipment Required:

Upper Body

Lower Body

Shoes

Upper Body

Lower Body

Shoes