Company Name
Tax Id (Optional)
What type of corporation?
S Corp
LLC
C Corp
Other
Autocompleted Address
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact and Payroll Information
Primary Contact
Phone
Email
example@example.com
How many full time employees do you employ?
Payroll Frequency
Weekly
Bi-Weekly
Payroll Submission Lead Time (example: 3 business days)
What payroll system do you use?
Please Select
ADP (RUN, Workforce Now, Vantage, etc.)
Paychex
Gusto
Paycom
Ceridian / Dayforce
OnPay
Rippling
QuickBooks Payroll (Intuit)
Patriot Payroll
Justworks
Deel
Remote
Other
Contact Name
Contact email
example@example.com
Company Code
Do You Offer Major Medical Insurance
Yes
No
Provider
Plan Name/Type
Contact Name
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