PAYROLL KICKOFF FORM
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Company Information
Legal Business Name
DBA (if applicable)
EIN (Employer Identification Number)
Business Structure
Please Select
LLC
S-Corp
C-Corp
Sole Proprietor
Partnership
Nonprofit
Other
Date Business Started
-
Month
-
Day
Year
Date
Primary Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Industry
Primary Contact Name
Title
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
State & Tax Registration Information
States where employees work
State Employer Account Number(s)
State Unemployment Insurance (SUI) Account Number(s)
SUI Tax Rate(s)
Federal Deposit Schedule
Monthly
Semiweekly
Unsure
Has the company received IRS or state tax notices in the past 12 months?
Yes
No
If Yes: Upload tax notices
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Payroll Setup Details
Pay Frequency
Please Select
Weekly
Biweekly
Semi-monthly
Monthly
Next Scheduled Pay Date
-
Month
-
Day
Year
Date
Payroll Start Date With Us
-
Month
-
Day
Year
Date
Pay Type(s)
Salary
Hourly
Commission
Bonus
Mixed
Overtime Policy Description
Standard Work Hours Per Week
Time Tracking System Used
Who will submit payroll hours and approve payroll?
Employee Information
Number of Employees
Upload Employee Information Spreadsheet
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Benefits & Deductions
Does the company offer benefits?
Yes
No
If Yes:Type of Benefits Offered
Health
Dental
Vision
401(k)
HSA
FSA
Other
Are there wage garnishments or court-ordered deductions?
Yes
No
If Yes:
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Workers’ Compensation
Insurance Carrier
Policy Number
Policy Effective Dates
Class Codes
Banking & Payroll Funding
Business Bank Name
Routing Number
Account Number
Account Type
Please Select
Savings
Checking
Authorize automatic payroll tax withdrawals?
Yes
No
Prior Payroll History (If Switching Providers)
Are you switching payroll providers?
Yes
No
If Yes: Previous Provider Name
First Name
Last Name
Date of Last Payroll Run
-
Month
-
Day
Year
Date
Upload Year-to-Date Payroll Reports
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Upload Most Recent Form 941
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State Filings Up to Date?
Yes
No
Authorization
Authorized Representative Name
First Name
Last Name
Title
Signature
Date
-
Month
-
Day
Year
Date
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