New Hire Employment Package

New Hire Employment Package
Welcome to Manie Happy Homecare LLC.We look forward to working with you and hope you enjoy your working experience with us.
- Please complete the required areas (marked with a red asterisk * ) throughout the packet.
- When finished, you will need to electronically submit this packet by clicking on Submit at the end. An option to print a copy of this form is available at the end.
- You will also need to bring the following to your first day on the job:
  - Valid Driver License, or other acceptable ID listed under I-9, page 3.
  - Social Security Card, Birth Certificate, or Passport
  - At the beginning of your first shift, you will sign your completed W-4, I-9, Authorization for Direct Deposit, and Acknowledgment of Receipt of Employee Handbook which will be generated by filling out this New Hire Employment Package.
- All items must be submitted to your Manager before you begin working your first shift. Late items will result in a delayed paycheck.
- Please contact David Shawkat at (207) 272-1195 or (207) 712-8282 if you have any questions about your employment with Manie Happy Homecare LLC.
Personal Information
Name*

First NameLast Name
Social Security Number*
XXX-XX-XXX
Personal Email*
example@example.com
Cell Number*

Area CodePhone Number
Home Number

Area CodePhone Number
Personal Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
African American/BlackAmerican Indian/Alaskan NativeAsianHispanic or LatinoNative Hawaiian/Pacific IslanderTwo or more racesUnknownWhite
YesNo
YesNo
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
SpouseParentChildRelativeFriendOther
Cell PhoneHome PhoneWork Phone
Please provide phone numbers, specifically the number they are best to be contacted on.
Cell Number

Area CodePhone Number
Home Number

Area CodePhone Number
Work Number

Area CodePhone Number
Miscellaneous Information
Yes*No
*If Yes, Please Give Name of Relative

First NameLast Name
What are the days of the week you are available to work?
Days of the week (M,Tu,W,Th,F,Sa,Su)
What hours of the day are you available to work?
Ex: 8am-12pm, 4pm-8pm
Are there days of the week or hours in a day that you cannot work due to school, family obligations or other employment?
Driver License Authorization
As an employee of Maine Happy Homecare LLC. and over the age of 18, I consent and authorize Maine Happy Homecare LLC. and its designees to obtain information from the STATE Driver License Division (“Division”) relating to my driving record. Information to be provided by the Division includes name, driver’s license number, date of issuance, whether the license is valid, driving incidents, and reports, and other similar driver information specific to employees of Maine Happy Homecare LLC.
N/A
Drivers license upload

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Signature for Driver License Authorization*
Date Signed*

MonthDayYear
Date
W-4
The link to the Federal Form W-4 is below. A new tab will open when you click on it. The form is a fillable PDF that you will be able to download with your changes filled in. Complete Page 1, steps 1 through 4. Once you have referred to the instructions and withholding calculator that accompany the form, download the completed form with your changes to your computer.

Click Here to View and Fill-In the Federal Form W-4
Upload Your Completed W-4 Here

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You will sign your completed W-4 form at the beginning of your first shift with your manager.
I-9
The link to the Department of Homeland Security Form I-9 is below. A new tab will open when you click on it. The form is a fillable PDF that you will be able to download with your changes filled in. Complete Page 1 to the signature section of the form. Once you have referred to the instructions that accompany the form, download the completed form with your changes to your computer.

Click Here to View and Fill-In the Department of Homeland Security I-9
Upload Your Completed I-9 Here*

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You will sign your completed I-9 format the beginning of your first shift with your manager.
Maine Happy Homecare LLC. encourages and recommends all employees use direct deposit for their paychecks. If you do not have a bank account, please indicate below and a paper paycheck will be generated for you each pay period. (A paper check will be mailed and the process typically takes 2 to 3 additional days beyond direct deposits.)
Yes
Acknowledgment
I confirm that all information in this form is true and accurate.I agree that I have completed and uploaded the required documents: W-4, I-9, Authorization for Direct Deposit (If Applicable) and Employee Acknowledgment of Receipt of Employee Handbook
Applicant's Signature*
Date Signed*

MonthDayYear
Date
This is a fill in the blanks field. Please add appropriate blank fields and text.
Signature
Type a question
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Should be Empty:

New Hire Employment Package

Personal Information

Emergency Contact Information

Miscellaneous Information

Driver License Authorization

W-4

I-9

Acknowledgment