@Monroe Employee Information Sheet

@MONROE

2299 N. Florissant Ave.
Saint Louis, MO 63106

Tel 314.626.0825

atmonroellc@gmail.com
Employee Information Sheet
Job location:*
Job title:*
CONSUMER NAME*

First NameLast Name
EMPLOYEE NAME*

First NameLast Name
Employee Code*
SSN
STREET*
City*
State*
ZIP*
Phone Number*
Emergency Contact Home*
Phone Number*
Social Security #*
Date of Birth

MonthDayYear
Hire Date

MonthDayYear
Hourly Rate*
Salary Rate*
Other Rate*
Marital status (select one)*
If married note if spouse work*
Number of dependents *
Federal*
State*
Additional Federal tax withheld*
Additional state tax withheld*
City Tax*
Banking information Please include a voided check for direct deposit
Routing number*
Account number*
Please Sign and Date verifying all information is correct.*

Clear
Date*

MonthDayYear
Note Changes
Should be Empty: