"New Employee Set-Up Form - Timepays" - Massachusetts

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Download "New Employee Set-Up Form - Timepays" - Massachusetts

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One Credit Union Way Suite 208
Randolph, MA 02368
Telephone: 617-298-1000
Facsimile: 781-963-6800
New Employee Set-Up Form
Client # _____
Company Name: ______________________________
Employee Information
Employee ID/Time Card Number: ______________ Employee Name: _____________________________
Social Security Number: ___ - ___ - _____
Circle: Male or Female
Date of Birth: ____/____/_____
Date of Hire: ____/____/_____
Address:___________________________________________________
#
Street
City
State
Zip
Direct deposit (Attach form and bank documentation)
Wage information
Circle Pay Frequency: Weekly / Bi-Weekly / Semi-Monthly / Monthly
Salary per pay period of $_________ or Per Hour Rate of $ ________
Home Location: ________ Home Department __________
Additional Dept: ________ Rate of Pay $ _____
Additional Dept: ________ Rate of Pay $ _____
Taxes
Federal W4 info: Single or Married and #____ of Exemptions - Optional Extra withholding per pay period $______
State Employee Income taxes are withheld from _____
State Employer Unemployment taxes are paid to _____
Single or Married and #____ of Exemptions - Optional Extra withholding per pay period $______
Deductions
Name : ____________________ Amount / Percentage Per Payroll ___________
Name : ____________________ Amount / Percentage Per Payroll ___________
Benefits
Name : ____________________ Amount / Percentage Per Payroll ___________
Name : ____________________ Amount / Percentage Per Payroll ___________
Revised 2016-03-07
One Credit Union Way Suite 208
Randolph, MA 02368
Telephone: 617-298-1000
Facsimile: 781-963-6800
New Employee Set-Up Form
Client # _____
Company Name: ______________________________
Employee Information
Employee ID/Time Card Number: ______________ Employee Name: _____________________________
Social Security Number: ___ - ___ - _____
Circle: Male or Female
Date of Birth: ____/____/_____
Date of Hire: ____/____/_____
Address:___________________________________________________
#
Street
City
State
Zip
Direct deposit (Attach form and bank documentation)
Wage information
Circle Pay Frequency: Weekly / Bi-Weekly / Semi-Monthly / Monthly
Salary per pay period of $_________ or Per Hour Rate of $ ________
Home Location: ________ Home Department __________
Additional Dept: ________ Rate of Pay $ _____
Additional Dept: ________ Rate of Pay $ _____
Taxes
Federal W4 info: Single or Married and #____ of Exemptions - Optional Extra withholding per pay period $______
State Employee Income taxes are withheld from _____
State Employer Unemployment taxes are paid to _____
Single or Married and #____ of Exemptions - Optional Extra withholding per pay period $______
Deductions
Name : ____________________ Amount / Percentage Per Payroll ___________
Name : ____________________ Amount / Percentage Per Payroll ___________
Benefits
Name : ____________________ Amount / Percentage Per Payroll ___________
Name : ____________________ Amount / Percentage Per Payroll ___________
Revised 2016-03-07