The Payroll Department
New Hire WorksheetEMPLOYEE:_____________________________________________________________________________________FIRST MIDDLE LAST_____________________________________________________________________________________HOME ADDRESS CITY, STATE, ZIP CODE__________________________ ______________________________________________SOCIAL SECURITY NUMBER BIRTH DATE COUNTY OF RESIDENCE_______________________________________________________________________STATE YOU WILL BE WORKING IN EMAIL ADDRESS___________________________________TELEPHONE NUMBERFEDERAL WITHHOLDINGPlease attach Page 1 of the 2020 W4 STATE WITHHOLDINGTotal Number of allowances you are claiming: _____________Extra Withholding Amount: ____________________________EMPLOYEE SIGNATURE ____________________________________________________________EMPLOYER:_____________________________________________________________________________________NAME OF BUSINESS EMPLOYER IDENTIFICATION NUMBER_____________________________________________________________________________________BUSINESS ADDRESSEMPLOYEE’S HOURLY RATE: ____________ EMPLOYEE’S SALARY RATE: ____________EMPLOYEE’S HIRE DATE: ________________ DEPARTMENT: _________________________ ................
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