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EMPLOYEE INFORMATION SHEET
Complete this form for each employee.
General Information
Employee Name __________________________________
Address __________________________________
City, State, Zip __________________________________
Email Address __________________________________
Birth Date MM____/DD____/YY____
Hire Date MM____/DD____/YY____
Social Security No. __________________
Gender
Female
Male
Direct Deposit Information
Will this employee be paid by direct deposit?
Yes. If so, please complete the Authorization of Direct Deposit form
No
Tax Information
Please attach or specify the following information for this employee:
Attach completed federal Form W-4
Attach completed state withholding form. Only applicable if state income tax and filing
status/allowances are different from federal
Specify any payroll taxes that this employee is exempt from, such as state unemployment, social
security, or Medicare:
_________________________________________________________________________________
Specify any local taxes that need to be withheld from this employee’s paycheck:
_________________________________________________________________________________
Notes:
Pay Information
Which types of pay does this employee receive?
Salary $______ per ____
Hourly Rates (up to 8 different)
$_____ / hour
$_____ / hour
$_____ / hour
$_____ / hour
$_____ / hour
$_____ / hour
$_____ / hour
$_____ / hour
Overtime Pay
Double Overtime
Sick Pay
Holiday Pay
Vacation Pay
Bonus
Commission
Allowance
Reimbursement
Cash Tips
Paycheck Tips
Clergy Housing (Cash)
Clergy Housing (In-Kind)
Bereavement Pay
Group Term Life Insurance
S-Corp Owners Health Ins.
Personal Use of Company Car
Other: __________________