Payroll Setup Form
Personal Information
| Employee Information |
|---|
Name: | [Your Name] |
Address: | |
Email: | |
Phone Number: | |
Date of Birth: | |
Social Security Number: | |
Gender: | |
Marital Status: | |
Employment Details
| Description |
|---|
Job Title: | Product Manager |
Department: | |
Work Location: | |
Employment Type: | |
Work Schedule: | |
Employment Start Date: | |
Payment Information
| Description |
|---|
Bank Name | First National Bank |
Account Number | |
Routing Number | |
Payment Frequency | |
Deductions
| Description |
|---|
Pre-Tax Deductions | |
Retirement Contributions: | 5% of salary |
Health Insurance Premiums: | |
Post-Tax Deductions | |
Union Dues: | |
Charitable Donations: | |
Benefits Information
| Description |
|---|
Health Insurance | |
Plan Type: | PPO |
Dependents Covered: | |
Retirement Plan | |
Participation: | |
Emergency Contact Information
| Description |
|---|
Name: | [Nan Pacheco] |
Relationship: | |
Phone Number: | |
Signature and Date
Employee Signature: ________________________
Date: [September 21, 2078]
Employee Handbook Acknowledgment
I acknowledge that I have received and reviewed the company's employee handbook.
Please ensure that all fields above are properly filled out. Once you are finished, please submit this form to the payroll department.
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