Company Payroll Enrollment Form

Company Payroll Enrollment Form

Trucker Tax Service - 888-799-1099
Date

Month Day Year
Date
Once you have clicked on the "Submit" button below, client hereby authorizes Trucker Tax Service, Inc. to perform payroll services under the following pricing terms.

Set Up Fee: $75.00 per company (one-time fee)

$75.00 per month, per company

Includes one employee, unlimited pay periods

If you have more than one employee, there will be a year-end fee of $50.00 per additional employee for creating the additional W2s

Client may terminate agreement at any time, otherwise, agreement will automatically renew annually upon the date of this agreement.
Company Setup Information
Company Name
EIN
Company Type

Corporation LLC
Contact Name

First Name Last Name
Email
example@example.com
Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of Corporate Bank
Corp Bank Routing Number
Corp Bank Account Number
Employee Setup Information
Name

First Name Last Name
Date of Birth
Social Security Number
Email
example@example.com
Phone Number
Address (omit if same as above)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of Employee's Bank
Employee's Bank Routing Number
Employee's Bank Accounting Number
We direct deposit weekly pay checks, if you prefer a different schedule, please specify

Weekly Every Two Weeks Twice a Month Monthly
Pay Period Start Date
Annual Salary

Payroll Fees

Payroll - $75.00 ( $ 75.00 for each month )

This fee is a monthly payment that covers one employee with unlimited pay periods. Your first payment, debited today, will be a one-time set-up fee of $75.00.

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

After clicking on the "Submit" button below, please email your

completed W4 (https://www.irs.gov/pub/irs-pdf/fw4.pdf),

a copy of your Drivers License, and

a copy of a voided check or a screenshot of your bank account to

jodonnell@truckertaxservice.com
By pressing submit below you agree to the terms of this agreement.
Revision Date 8/09/2021
Should be Empty:

Company Payroll Enrollment Form

Company Setup Information

Employee Setup Information