Client Payroll Form

1
Would you like to add a client to payroll or remove them from payroll?
Please Select
Please Select
Add
Remove
2
Name of Client
First Name
Last Name
3
Supervisor
Please Select
Please Select
Amber McVay
Samantha Martin
Rebecca Sofranko
4
Program / Type
Summer Youth - CCMEP
Summer Youth - OOD
WIOA
OOD
5
Case Manager Email* This field is required.Email for Summer Youth Submission Receipt
example@example.com
6
Has this client been on our payroll before?
Yes
No
Unknown
7
Date work begins:
Date
Month
Day
Year
8
Please upload the following completed documents: I9, W4, IT4, Direct Deposit
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
9
Please list each client to remove from payroll.
10
Upload Relevant documents for client payroll removal.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
Notes
Should be Empty: