Current Employee Information Update Form

CURRENT EMPLOYEE CONTACT INFORMATION UPDATE FORM
PLEASE READ: This form is required for all current employees.
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Current employees that set up ADP access before they are no longer with the company can access their W2s on ADP for up to THREE years from their termination/resignation date.

If you do not register for ADP while you are a current employee, then you will not be able to register if you are no longer with the company per ADP policy. It is very important for you to register so that you can have ongoing electronic access to your pay stubs and w2s.
Employee Information:
Employee Name*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Telephone Number*
Format: (000) 000-0000.
Current Email Address*
example@example.com
Emergency Contact Information:
Emergency Contact Name*
Emergency Contact Phone Number*
Format: (000) 000-0000.
Emergency Contact Email*
Emergency Contact Relationship to Employee *
Signature*
Date*

MonthDayYear
Date
DISCLOSURE for DIGITAL DELIEVERY via ADP:

IMPORTANT DISCLOSURE INFORMATION 1) If you do not consent to electronic delivery, you will receive a paper W2 in the mail, which will be delivered to the address that we currently have on file. 2) Your consent to electronic delivery will apply to all future W2s unless consent is withdrawn by you (see point 4 below). 3) If for any reason you would like a paper copy of your W2 after you have consented to electronic delivery, you may submit a request via e-mail Christine@Honorworth.com or send a written request to Honorworth Homecare. Requesting a paper copy of your W2 will not be treated as a withdrawal of consent. 4) If you would like to withdraw your consent to electronic delivery, you may submit a notice via e-mail Christine@Honorworth.com or send a written request to Honorworth Homecare. Your consent is considered withdrawn on the date the Employer receives your written request to withdraw consent. The Employer will confirm the withdrawal and its effective date in writing. A withdrawal of consent does not apply to a W2 that was e-mailed to you in accordance with IRS Regulations before the effective date of the withdrawal of consent. 5) The Employer will cease providing Forms W2 to you electronically if you provide a notice to withdraw consent, if you are no longer employed by the Employer or if regulations change to prohibit the form of delivery. 6) If you need to update your contact information that we have on file, e-mail the update to Christine@honorworth.com or utilize this form. 7) We will update Google if there are any changes to the contact information of the Employer. 8) You will need a computer, printer and Adobe Acrobat software to access, print and retain your W2. 9) Your W2 may be required to be printed and attached to a federal, state or local income tax return.
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YesNo
Signature*
Date*

MonthDayYear
Date
Should be Empty:

CURRENT EMPLOYEE CONTACT INFORMATION UPDATE FORM

PLEASE READ: This form is required for all current employees.

Current employees that set up ADP access before they are no longer with the company can access their W2s on ADP for up to THREE years from their termination/resignation date.

Employee Information:

Emergency Contact Information:

DISCLOSURE for DIGITAL DELIEVERY via ADP: