PMLA- Employment Forms

Employer Name
Employer Email
Employer Phone Number
Welcome Aboard!
Dear Faculty Member,

Thank you for being a part of the {employerName} Professional Team!

Your work is very valuable to us and the {employerName} Human Resource Department is here to support your efforts.

In order to ensure that you are compensated accurately and in a timely fashion, please click through the forms below to complete and submit your required information and documents as soon as possible.

Please understand that if forms are submitted incomplete or late, we may not be able to properly review and process your compensation in a timely manner.

Thank you in advance for your cooperation!

Summary of Available Forms
- I9 Form - Employment Eligibility Verification
- W4 Forms - Federal & State (if applicable)
- Parsonage Form - Allowance Application for Clergy Staff (optional)
- QTR Form - Tuition Reduction Benefit for “exempt - full time” Staff (optional)
- Direct Deposit Form
Helpful Documents to Have Available Before you Start
- IDs: Passport, Driver's license and social security card.
- Financial Information: Previous year's tax returns and W2s.
- Housing Information (for Parsonage Form): Mortgage statement, real estate tax bill, homeowner's insurance policy, utilities bills, etc.
- Tuition Information (for QTR Form): Upcoming year's tuition agreement, name and address info of schools
- Banking Information: Bank account information and copy of blank check
If you have any questions or need any assistance filling out these forms, please feel free to contact us at {employerEmail} or at {employerPhone}.

Sincerely,

{employerName} Human Resource Department

Contact Information

Employee & Emergency Contact Information
Employee Information
Employee Name*

First Name and Middle InitialLast Name
Gender*
Salutation*
Preferred Name*
Please enter the name you will use for any future information or correspondence
Home Address*

(Street Number and Name)

Apt #

City or TownState

ZIP Code
E mail Address*
example@example.com
Cell Phone*
Emergency Contact Information
Contact #1
Emergency Contact Name*
Relationship to Employee*
Daytime Telephone*
E mail Address*
example@example.com
Contact #2
Emergency Contact Name*
Relationship to Employee*
Daytime Telephone*
E mail Address*
example@example.com

Parsonage Designation

Worksheet
- The Parsonage Housing Allowance is a designated portion of a clergy member’s compensation used to cover housing expenses. This allowance may include rent, mortgage payments, utilities, property taxes, and other related costs.
- To comply with tax and school policies, clergy members must complete the Parsonage Housing Expense Form, detailing their eligible housing expenses.
- This form ensures proper documentation and ensures the amount is allocated to the appropriate allowance. Staff members must submit this form annually or whenever there are significant changes to their housing costs.
- For any tax-related questions regarding parsonage, please consult your accountant, as HR is not able to provide tax guidance or advice.
Do you want to request parsonage?*

YesNo
Important Information - Please Read Before Completing this Form
- Compensation received as a parsonage allowance is not subject to federal income tax and should not be included in taxable income on your Form 1040. However, it is subject to self-employment tax and must be reported on Schedule SE of your tax return. Please consult your accountant for guidance on how this applies to your specific situation.
- The aggregate parsonage allowance may not exceed the fair rental market value of the home including furnishings (and garage) plus utilities. Excess amounts should be reported as income on your tax return.
- Evidence of expenses should be kept in your files.
- The Board will need review and approve this request prior to any parsonage payments being issued. You will receive a formal copy of the approval, please keep a copy for your records.
Are you teaching in a Judaics or religious oriented position?*

YesNo
What is your qualification for parsonage?*

Rabbanic Ordinance/SemichaSeminary/Teaching cerificateBachelor or equivalent in Talmudic lawParsonage qualification certificateOther
Housing Expense Summary
Set forth are the estimated expenditures anticipated during the {schoolYear268} school year, to maintain my home.
Rent/Mortgage Payments (Yearly)
principal & Interest
Real Estate Taxes (Yearly)
Renter's/Homeowners Insurance (Yearly)
Utilities (Yearly)
Repairs & Maintenance (Yearly)
Home Improvements (Yearly)
Furnishings, Appliances, Home Decor, Household Goods (Yearly)
Other Allowable Expenses (Yearly)
Total Parsonage Allowance Requested*
The above is an accurate estimate of my anticipated housing expenses. These estimated expenditures shall remain in effect unless modified.
Signature of Clergy*

Clear
Date*

MonthDayYear
Date

Do we have your direct deposit information on file already?*

Yes, please continue using the same information.No - I would like to submit new or update the information you have
Authorization for Direct Deposit
Declaration
I authorize {employerName} to deposit my pay automatically to the account(s) {doWe} and, if necessary, to adjust or reverse a deposit for any payroll entry made to my account in error. This authorization will remain in effect until I cancel it in writing and in such time as to afford {employerName} a reasonable opportunity to act on it.
Account Information
Number of Bank Accounts
Would you like you pay to be split based on a dollar amount or based on a percentage?*

Dollar AmountPercentage
Name on Bank Account*
Bank Account Number*
Bank Routing Number*
Account Type*

CheckingSavings
Please attach a voided check for the bank account to which funds should be deposited.

Browse Files

Cancelof
Percentage of pay to be deposited into Account #1. The remaining pay will be deposited into Account #2.*
Dollar Amount to be deposited into account #1. The remaining amount will be deposited into Account #2.*
Account #2 Information
Name on Bank Account*
Bank Account Number*
Bank Routing Number*
Account Type*

CheckingSavings
Please attach a voided check for the bank account to which funds should be deposited.

Browse Files

Cancelof
By requesting authorization for direct deposit, I understand that {employerName} is not committing itself or implying that payroll will be issued via direct deposit at this time. {employerName} will keep this authorization in my employee file in the event direct deposit becomes a possibility or is needed from time to time.
Employee Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Welcome Aboard!

Contact Information

Employee Information

Emergency Contact Information

Contact #1

Contact #2

Employment Information

Employment Eligibility Verification

USCIS Form I-9

Section 1

Section 2

FORM W-4

Step 1: Personal Information

Step 2: Multiple Jobs or Spouse Works

Step 3: Claim Dependents

Step 4: Other Adjustments (optional)

Step 5: Sign Here

EDD Form

Allowances

Additional Withholding

Parsonage Designation

Housing Expense Summary

QTR Benefit - Qualified Tuition Reduction

Designation Information

Total Designation

Authorization for Direct Deposit

Declaration

Account Information

Account #2 Information