Payroll Intake Form

First Name

Last Name

Email *

Phone *

Business Name:

FEIN (Federal Employer Identification Number)

Address

Street Address

Country

State

City

Postal Code

Who is authorized to approve payroll? (Please Provide Name(s) and Title(s))

Pay frequency — weekly, biweekly, semi-monthly, monthly

Number of Employees:

Current payroll provider, if any?

Reason for switching, if applicable.

Do any employees have split deposit arrangements — for example splitting pay between two accounts?

Do you offer benefits — health insurance, retirement, PTO?

If yes, which benefits need to be deducted from payroll?

Health insurance

Retirement

PTO

Other

Do you have any garnishments or child support orders on current employees?

Preferred payroll start date

Do you need prior payroll history imported?

Do you need W2s or 1099s handled?

Please upload the following documents: Current employee list, W-4s, I-9s, and/or prior payroll records if you are switching providers.

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

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