New Hire Form

New Hire Form

To be completed by the EMPLOYER only.
Route this form to:
Select your Payroll Specialist. You do not have to enter their email. Form will be emailed automatically to the person selected.
Effective Date (if not your next pay date)

MonthDayYear
Date
Company Name
Hire Date

MonthDayYear
Date
Employment Category
ID Type
SSN
First name (legal name, no nicknames)
Preferred Name
Middle Name
Last Name
Prefix
Suffix
Self-Service Email
Marital Status
Address
City
ZIP Code
State
Home Phone
Mobile Phone
Personal Email
Birth Date

MonthDayYear
Gender
Pay Info
Pay Group
Pay Type
Other pay types
Frequency
Salary per pay period (*not annual salary*)
If you see error message that input is greater than the maximum value, please confim that you entered salary per pay period, not annual salary.
Hourly Rate
Alternate Rate 1 (description)
Alternate Rate ($)
Alternate Rate 2 (description)
Alternate Rate ($)
Deductions per pay period
Deduction 1
Deduction Amount 1
Deduction 2
Deduction Amount 2
Deduction 3
Deduction Amount 3
Deduction 4
Deduction Amount 4
Deduction 5
Deduction Amount 5
Deduction 6
Deduction Amount 6
Does employee have a garnishment?
Attach Garnishment Order (if applicable)

Cancelof
Retirement deductions per pay period
Type of Retirement Account
If "Other," enter type of account
Is employee contribution fixed dollar amount or percent of pay?
Employee Contribution
Employer Match %
Accruals per pay period
Sick Rate
Vacation Rate
Personal Rate
PTO Rate
Tax Withholdings
Filing Status
Number of children under 17
Number of children under 17
Amount for qualifying children/dependents (Step 3 of W4)
Additional Withholding (Step 4 of W4)
Special instructions for taxes: visa, clergy, additional withholding, etc.
Do not submit W4 or State withholding forms. All info should be on this form.
Signature
Please verify that you are human
Should be Empty: