New Contractor

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Company ID*
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Contractor Number - If not known please leave "C" in the box.*
Business Name or Last Name*
First Name
MI
Address 1*
Address 2
City*
State*
Zip Code*
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County of Residence as of Jan 1 of CURRENT YEAR*
SSN/FEIN*
Salary*
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Gender
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Department
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1099 Type
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Hire Date
MM/DD/YY
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Birth Date
MM/DD/YY
Hourly Rate*
Salary Per Pay Period*
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Sort Alf*
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Craft*
E-mail address (For E-mailed Paystubs)
Direct Deposit Option*
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Dept 1 Number*
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Dept 1 Rate*
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Dept 2 Number*
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Dept 2 Rate*
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Dept 3 Number*
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Dept 3 Rate
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Dept 4 Number*
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Dept 4 Rate
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Dept 5 Number*
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Dept 5 Rate*
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Dept 7 Number*
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Dept 7 Rate*
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Dept 8 Number*
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Dept 8 Rate*
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Dept 9 Number*
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Dept 9 Rate*
Primary Direct Deposit Routing*
Primary Direct Deposit Account*
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FED Exempt*
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SWH Status
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State Withholding Allowances*
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State Withholding Additional Amount
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State Exempt*
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E-w2 Y*
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eStub rcve - Y if routing >0*
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Employee type?*
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SOC Code (6-digits)*
Don't know your SOC code? Copy and paste this link in a new window: http://info.itsc.org/occucoder/
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Post 19 W-4*
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Box 2c W4
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W-4 Federal Withholding Status*
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W-4 Step 3: Claim Dependents (Enter Total)
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W-4 Step 4(a): Other income (not from jobs)
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W-4 Step 4(b): Deductions
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W-4 Step 4(c) Extra Withholding each PAY PERIOD
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Single?
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Married?
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Head of Household?
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W-4 Step 2c?
Total Compensation Current Year
Total Compensation Previous Year
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Today's Date
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E-mail address To Send Pre-Filled Documents*
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First Four Letters of Company Name2
Website Terms of Use*
- I agree to: Website Terms of Use.

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