| AUTOMATED PAYROLL SOLUTIONS, LLC P.O. BOX 702 SIKESTON, MO. 63801 573-471-1983 |
New Employee Payroll Information
Employer: _____________________________________________________
Employee Name: _______________________________________________
Address: ______________________________________________________
City: _________________________ State: ______________ Zip: _________
Social Security #: ______ - ____ - ______ DOB: _____ / _____ / _____
Date of Hire: _____ / _____ / _____ __Male __Female
Rate of Pay: ______________ __Per hour __Salary
Department / Location: ___________________________________________
Deduction / Garnishments
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Other Information : _______________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
NOTE: In addition to this form submit copies of the federal form W-4 and
State form W-4 If applicable also submit direct deposit form.
Employer: _____________________________________________________
Employee Name: _______________________________________________
Address: ______________________________________________________
City: _________________________ State: ______________ Zip: _________
Social Security #: ______ - ____ - ______ DOB: _____ / _____ / _____
Date of Hire: _____ / _____ / _____ __Male __Female
Rate of Pay: ______________ __Per hour __Salary
Department / Location: ___________________________________________
Deduction / Garnishments
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Description:________________________ Amt:$_________ Freq:__________
Other Information : _______________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
NOTE: In addition to this form submit copies of the federal form W-4 and
State form W-4 If applicable also submit direct deposit form.
