New Client Enrollment

Legal Filing Name (Corporate Name or Owner's Name)

Company Name (DBA)

Street Address

Suite

City

State

Zip Code

Phone Number

Fax Number

Owner(s)

Name of Contact(s) Authorized to Discuss Payroll

E-mail Address

Federal Employer Identification Number (EIN)

Employment Development Department State Identification Number

I am currently applying to the state for an EDD number.

Payroll Information

Approximate Number of Employees

Pay Frequency

Will your company be using Direct Deposit?

Would you prefer to have your checks pre-signed?

Payroll Delivery Method

The first payroll we want you to process will be dated on

Other Requirements

Please select any additional Requirements

Copy of voided check (General or Payroll Account)
Employee W-4's
Employee year-to-date breakdowns (if applicable)
Year-to-date tax payments made (if applicable)
Copy of current year tax returns (if applicable)
Employee set-up worksheet or equivalent

Your Tax Payment Frequency

*If you are unsure, please do not guess. An incorrect deposit frequency can lead to penalties.

Are you required to make your tax payments electronically through EFTPS?

Which federal tax form are you required to file?

Form 941 - Quarterly Tax Return
Form 944 - Annual Tax Return
Form 943 - Agricultural Tax Return

Please give us the starting check number you would like to have printed on your payroll checks.

Special Instructions

Please let us know if you were referred by another customer.

California Business Payroll Specialists

New Client Enrollment

Payroll Information

Other Requirements

Services

Associations

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