"Employee New Hire/Change Form - Onepoint"

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Company: ____________________________
Employee New Hire/Change Form
Employee New Hire
Employee Change
Employee Termination
Employee Number _______________
First Name _____________________ MI __________ Last Name _______________________________
Address _______________________________________________ Apt _______________
City ______________________________ State __________ Zip _______________
SSN __________-________-____________ Home Phone (__________) __________-____________________
Hire Date _____/_____/_____
Birth Date _____/_____/_____
Termination Date _____/_____/_____
Department _______________
Rate of Pay
Salary $__________._____ (per pay period)
FT/PT
Hourly $__________._____
Title _____________________
None
to be determined per pay period
Income Tax State __________ Unemployment State __________ Locality _________________________
Federal Marital Status __________ # of Exemptions __________
Exempt? Y/N
Additional Amount $__________._____
(if different)
State Marital Status __________ # of Exemptions __________
Exempt? Y/N
Additional Amount $__________._____
Deductions
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Other: ______________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Company: ____________________________
Employee New Hire/Change Form
Employee New Hire
Employee Change
Employee Termination
Employee Number _______________
First Name _____________________ MI __________ Last Name _______________________________
Address _______________________________________________ Apt _______________
City ______________________________ State __________ Zip _______________
SSN __________-________-____________ Home Phone (__________) __________-____________________
Hire Date _____/_____/_____
Birth Date _____/_____/_____
Termination Date _____/_____/_____
Department _______________
Rate of Pay
Salary $__________._____ (per pay period)
FT/PT
Hourly $__________._____
Title _____________________
None
to be determined per pay period
Income Tax State __________ Unemployment State __________ Locality _________________________
Federal Marital Status __________ # of Exemptions __________
Exempt? Y/N
Additional Amount $__________._____
(if different)
State Marital Status __________ # of Exemptions __________
Exempt? Y/N
Additional Amount $__________._____
Deductions
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Description ______________________________ Amount __________._____ (per pay period) Goal __________._____
Other: ______________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________