Bank Information for Direct Deposit of your Payroll Check
Name*
First Last
Bank Name*
Bank Routing Number: (9 Numbers Lower Left Portion of Check) Here's a link to help you locate it: Click here for examples
Enter 9 digit routing number here:*
Bank Account Number:*
FORM W-4 INFORMATION
W-4 Withholding Information
If you would like to see the current IRS W-4 form to view options & instructions Click here.
Name*
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Withholding*
- Single or Married Filing Seperately
- Married filing jointly or Qualifying widow(er)
- Head of household (Check only if you're unmarried and pay more than half the cost of keeping up a home for yourself and a qualifying individual)
Total Number of Dependents you are claiming?
Social Security Number:*
Date*
MM slash DD slash YYYY
Signature (e-signature) - Type full name:*

New Hire Bank Deposit & W-4 Information

FORM W-4 INFORMATION