Company Payroll Enrollment Form

Company Payroll Enrollment Form
Date

MonthDayYear
Date
This agreement Includes one employee with unlimited pay periods and you may terminate agreement at any time.
Company Setup Information
Company Name
EIN
Company Type

CorporationLLC
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Corporate Bank
Corp Bank Routing Number
Corp Bank Account Number
Employee Setup Information
Name

First NameLast Name
Date of Birth
Social Security Number
Email
example@example.com
Phone Number
Address (omit if same as above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Employee's Bank
Employee's Bank Routing Number
Employee's Bank Accounting Number
We direct deposit weekly pay checks, if you prefer a different schedule, please specify

WeeklyEvery Two WeeksTwice a MonthMonthly

My Products

Payroll - $75.00$75.00

This fee is a monthly payment that covers one employee with unlimited pay periods. Your first payment, debited today, will be a one-time set-up fee of $75.00.

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

After clicking on the "Submit" button below, please email your

completed W4 (https://www.irs.gov/pub/irs-pdf/fw4.pdf),

a copy of your Drivers License, and

a copy of a voided check or a screenshot of your bank account to

jodonnell@truckertaxservice.com
By pressing submit below you agree to the terms of this agreement.
Revision Date 1/26/2025
Should be Empty:

Company Payroll Enrollment Form

Company Setup Information

Employee Setup Information