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COLORADO PEO NEW HIRE PACKET

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1430 E Missouri Ave Suite B155-Phoenix, AZ 85014- Phone (602)778-9856- Fax (602)-778-9857
www.sunwestes.com
COLORADO
PEO
NEW HIRE PACKET
Congratulation on your recent employment! Your employer, also referred to as the worksite employer, has chosen to work with Sunwest
Employer Services, Inc. (Sunwest). Sunwest is an employee leasing company otherwise known as a Professional Employer Organization
(PEO). As a PEO, Sunwest has contracted with your worksite employer to create a co-employer relationship. Through the co-employer
relationship, Sunwest becomes your employer of record for payroll and tax reporting purposes.
Employee Name: __________________________, __________________________, _____
Please Print: Last Name First Name Initial
Included in this packet are seven (7) forms you must sign and return to the Sunwest
Employer Services Inc., Payroll Department.
9 New Employee Information Form
9 IRS Form W-4
9 Form I-9, Employment Eligibility Verification
9 Affirmation of Legal Work Status
9 Employee Authorization Agreement For Direct Depos
it
9 Employer Request For Disclosure Of Wage Assignment Order To Provide Child
Support
9 Basic Term Life Designation Of Primary And Contingent Beneficiary – Only
Applicable To Employees That Work 30 Or More Hours Per Week
1430 E Missouri Ave Suite B155-Phoenix, AZ 85014- Phone (602)778-9856- Fax (602)-778-9857
www.sunwestes.com
NEW EMPLOYEE INFORMATION FORM
PERSONAL DATA – AS SHOWN ON CURRENT SOCIAL SECURITY CARD
First Name (name must match the name on latest Social Security Card) Middle Last
Social Security Number Date of Birth
Address
City/State/Zip Home Phone
( )
Emergency Contact Name
Relationship
Address
Emergency Contact Phone
( )
Employee’s Signature
Date
Personal Email Address (Please note that any applicable benefits related information will be emailed to you)
Business Email Address
THIS SECTION MUST BE COMPLETED BY THE WORK-SITE EMPLOYER
Employee Job Title
Job Function (e.g. Clerical)
Division/Department
Workers’ Compensation Code
Stat
e_________
Client Date of Hire
Full-Time Part-Time Seasonal Piecework
PAY CODE
Hourly employee non-exempt from overtime per the Fair Labor Standards Act (FLSA)
Salaried employee not-exempt from overtime per the Fair Labor Standards Act (FLSA)
Salaried employee exempt from overtime per the Fair Labor Standards Act (FLSA)
EMPLOYEE’S PAY FREQUENCY
Monthly Rate: $ Per Year
Semi-Monthly Month
Bi-Weekly Pay Period
Weekly Hour
Form W-4 (2018)
Future developments. For the latest
information about any future developments
related to Form W-4, such as legislation
enacted after it was published, go to
www.irs.gov/FormW4.
Purpose. Complete Form W-4 so that your
employer can withhold the correct federal
income tax from your pay. Consider
completing a new Form W-4 each year and
when your personal or financial situation
changes.
Exemption from withholding. You may
claim exemption from withholding for 2018
if both of the following apply.
• For 2017 you had a right to a refund of all
federal income tax withheld because you
had no tax liability, and
• For 2018 you expect a refund of all
federal income tax withheld because you
expect to have no tax liability.
If you’re exempt, complete only lines 1, 2,
3, 4, and 7 and sign the form to validate it.
Your exemption for 2018 expires February
15, 2019. See Pub. 505, Tax Withholding
and Estimated Tax, to learn more about
whether you qualify for exemption from
withholding.
General Instructions
If you aren’t exempt, follow the rest of
these instructions to determine the number
of withholding allowances you should claim
for withholding for 2018 and any additional
amount of tax to have withheld. For regular
wages, withholding must be based on
allowances you claimed and may not be a
flat amount or percentage of wages.
You can also use the calculator at
www.irs.gov/W4App to determine your
tax withholding more accurately. Consider
using this calculator if you have a more
complicated tax situation, such as if you
have a working spouse, more than one job,
or a large amount of nonwage income
outside of your job. After your Form W-4
takes effect, you can also use this
calculator to see how the amount of tax
you’re having withheld compares to your
projected total tax for 2018. If you use the
calculator, you don’t need to complete any
of the worksheets for Form W-4.
Note that if you have too much tax
withheld, you will receive a refund when you
file your tax return. If you have too little tax
withheld, you will owe tax when you file your
tax return, and you might owe a penalty.
Filers with multiple jobs or working
spouses. If you have more than one job at
a time, or if you’re married and your
spouse is also working, read all of the
instructions including the instructions for
the Two-Earners/Multiple Jobs Worksheet
before beginning.
Nonwage income. If you have a large
amount of nonwage income, such as
interest or dividends, consider making
estimated tax payments using Form 1040-
ES, Estimated Tax for Individuals.
Otherwise, you might owe additional tax.
Or, you can use the Deductions,
Adjustments, and Other Income Worksheet
on page 3 or the calculator at www.irs.gov/
W4App to make sure you have enough tax
withheld from your paycheck. If you have
pension or annuity income, see Pub. 505 or
use the calculator at www.irs.gov/W4App
to find out if you should adjust your
withholding on Form W-4 or W-4P.
Nonresident alien. If you’re a nonresident
alien, see Notice 1392, Supplemental Form
W-4 Instructions for Nonresident Aliens,
before completing this form.
Specific Instructions
Personal Allowances Worksheet
Complete this worksheet on page 3 first to
determine the number of withholding
allowances to claim.
Line C. Head of household please note:
Generally, you can claim head of
household filing status on your tax return
only if you’re unmarried and pay more than
50% of the costs of keeping up a home for
yourself and a qualifying individual. See
Pub. 501 for more information about filing
status.
Line E. Child tax credit. When you file
your tax return, you might be eligible to
claim a credit for each of your qualifying
children. To qualify, the child must be
under age 17 as of December 31 and must
be your dependent who lives with you for
more than half the year. To learn more
about this credit, see Pub. 972, Child Tax
Credit. To reduce the tax withheld from
your pay by taking this credit into account,
follow the instructions on line E of the
worksheet. On the worksheet you will be
asked about your total income. For this
purpose, total income includes all of your
wages and other income, including income
earned by a spouse, during the year.
Line F. Credit for other dependents.
When you file your tax return, you might be
eligible to claim a credit for each of your
dependents that don’t qualify for the child
tax credit, such as any dependent children
age 17 and older. To learn more about this
credit, see Pub. 505. To
reduce the tax
withheld from your pay by taking this credit
into account, follow the instructions on line
F of the worksheet. On the worksheet, you
will be asked about your total income. For
this purpose, total income includes all of
Separate here and give Form W-4 to your employer. Keep the worksheet(s) for your records.
Form W-4
Department of the Treasury
Internal Revenue Service
Employee’s Withholding Allowance Certificate
a
Whether you
’
re entitled to claim a certain number of allowances or exemption from withholding is
subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.
OMB No. 1545-0074
2018
1 Your first name and middle initial Last name
Home address (number and street or rural route)
City or town, state, and ZIP code
2 Your social security number
3
Single Married Married, but withhold at higher Single rate.
Note: If married filing separately, check “Married, but withhold at higher Single rate.”
4
If your last name differs from that shown on your social security card,
check here. You must call 800-772-1213 for a replacement card.
a
5 Total number of allowances you’re claiming (from the applicable worksheet on the following pages) . . . 5
6 Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . . 6
$
7 I claim exemption from withholding for 2018, and I certify that I meet both of the following conditions for exemption.
• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and
• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.
If you meet both conditions, write “Exempt” here . . . . . . . . . . . . . . .
a
7
Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete.
Employee’s signature
(This form is not valid unless you sign it.)
a
Date
a
8 Employer’s name and address (Employer: Complete boxes 8 and 10 if sending to IRS and complete
boxes 8, 9, and 10 if sending to State Directory of New Hires.)
9 First date of
employment
10 Employer identification
number (EIN)
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Cat. No. 10220Q
Form W-4 (2018)
Form W-4 (2018)
Page 2
your wages and other income, including
income earned by a spouse, during the year.
Line G. Other credits. You might be able
to reduce the tax withheld from your
paycheck if you expect to claim other tax
credits, such as the earned income tax
credit and tax credits for education and
child care expenses. If you do so, your
paycheck will be larger but the amount of
any refund that you receive when you file
your tax return will be smaller. Follow the
instructions for Worksheet 1-6 in Pub. 505
if you want to reduce your withholding to
take these credits into account.
Deductions, Adjustments, and
Additional Income Worksheet
Complete this worksheet to determine if
you’re able to reduce the tax withheld from
your paycheck to account for your itemized
deductions and other adjustments to
income such as IRA contributions. If you
do so, your refund at the end of the year
will be smaller, but your paycheck will be
larger. You’re not required to complete this
worksheet or reduce your withholding if
you don’t wish to do so.
You can also use this worksheet to figure
out how much to increase the tax withheld
from your paycheck if you have a large
amount of nonwage income, such as
interest or dividends.
Another option is to take these items into
account and make your withholding more
accurate by using the calculator at
www.irs.gov/W4App. If you use the
calculator, you don’t need to complete any
of the worksheets for Form W-4.
Two-Earners/Multiple Jobs
Worksheet
Complete this worksheet if you have more
than one job at a time or are married filing
jointly and have a working spouse. If you
don’t complete this worksheet, you might
have too little tax withheld. If so, you will
owe tax when you file your tax return and
might be subject to a penalty.
Figure the total number of allowances
you’re entitled to claim and any additional
amount of tax to withhold on all jobs using
worksheets from only one Form W-4. Claim
all allowances on the W-4 that you or your
spouse file for the highest paying job in
your family and claim zero allowances on
Forms W-4 filed for all other jobs. For
example, if you earn $60,000 per year and
your spouse earns $20,000, you should
complete the worksheets to determine
what to enter on lines 5 and 6 of your Form
W-4, and your spouse should enter zero
(“-0-”) on lines 5 and 6 of his or her Form
W-4. See Pub. 505 for details.
Another option is to use the calculator at
www.irs.gov/W4App to make your
withholding more accurate.
Tip: If you have a working spouse and your
incomes are similar, you can check the
“Married, but withhold at higher Single
rate” box instead of using this worksheet. If
you choose this option, then each spouse
should fill out the Personal Allowances
Worksheet and check the “Married, but
withhold at higher Single rate” box on Form
W-4, but only one spouse should claim any
allowances for credits or fill out the
Deductions, Adjustments, and Additional
Income Worksheet.
Instructions for Employer
Employees, do not complete box 8, 9, or
10. Your employer will complete these
boxes if necessary.
New hire reporting. Employers are
required by law to report new employees to
a designated State Directory of New Hires.
Employers may use Form W-4, boxes 8, 9,
and 10 to comply with the new hire
reporting requirement for a newly hired
employee. A newly hired employee is an
employee who hasn’t previously been
employed by the employer, or who was
previously employed by the employer but
has been separated from such prior
employment for at least 60 consecutive
days. Employers should contact the
appropriate State Directory of New Hires to
find out how to submit a copy of the
completed Form W-4. For information and
links to each designated State Directory of
New Hires (including for U.S. territories), go
to www.acf.hhs.gov/programs/css/
employers.
If an employer is sending a copy of Form
W-4 to a designated State Directory of
New Hires to comply with the new hire
reporting requirement for a newly hired
employee, complete boxes 8, 9, and 10 as
follows.
Box 8. Enter the employer’s name and
address. If the employer is sending a copy
of this form to a State Directory of New
Hires, enter the address where child
support agencies should send income
withholding orders.
Box 9. If the employer is sending a copy of
this form to a State Directory of New Hires,
enter the employee’s first date of
employment, which is the date services for
payment were first performed by the
employee. If the employer rehired the
employee after the employee had been
separated from the employer’s service for
at least 60 days, enter the rehire date.
Box 10. Enter the employer’s employer
identification number (EIN).
Form W-4 (2018)
Page 3
Personal Allowances Worksheet (Keep for your records.)
A Enter “1” for yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
B Enter “1” if you will file as married filing jointly . . . . . . . . . . . . . . . . . . . . . . . B
C Enter “1” if you will file as head of household . . . . . . . . . . . . . . . . . . . . . . . C
D Enter “1” if:
{
• You’re single, or married filing separately, and have only one job; or
• You’re married filing jointly, have only one job, and your spouse doesn’t work; or
• Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.
}
D
E Child tax credit. See Pub. 972, Child Tax Credit, for more information.
• If your total income will be less than $69,801 ($101,401 if married filing jointly), enter “4” for each eligible child.
• If your total income will be from $69,801 to $175,550 ($101,401 to $339,000 if married filing jointly), enter “2” for each
eligible child.
• If your total income will be from $175,551 to $200,000 ($339,001 to $400,000 if married filing jointly), enter “1” for
each eligible child.
• If your total income will be higher than $200,000 ($400,000 if married filing jointly), enter “-0-” . . . . . . .
E
F Credit for other dependents.
• If your total income will be less than $69,801 ($101,401 if married filing jointly), enter “1” for each eligible dependent.
• If your total income will be from $69,801 to $175,550 ($101,401 to $339,000 if married filing jointly), enter “1” for every
two dependents (for example, “-0-” for one dependent, “1” if you have two or three dependents, and “2” if you have
four dependents).
• If your total income will be higher than $175,550 ($339,000 if married filing jointly), enter “-0-” . . . . . . . F
G Other credits.
If you have other credits, see Worksheet 1-6 of Pub. 505 and enter the amount from that worksheet here
.. G
H Add lines A through G and enter the total here . . . . . . . . . . . . . . . . . . . . . .
a
H
For accuracy,
complete all
worksheets
that apply.
{
• If you plan to itemize or claim adjustments to income and want to reduce your withholding, or if you
have a large amount of nonwage income and want to increase your withholding, see the Deductions,
Adjustments, and Additional Income Worksheet below.
• If you have more than one job at a time or are married filing jointly and you and your spouse both
work, and the combined earnings from all jobs exceed $52,000 ($24,000 if married filing jointly), see the
Two-Earners/Multiple Jobs Worksheet on page 4 to avoid having too little tax withheld.
• If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form
W-4 above.
Deductions, Adjustments, and Additional Income Worksheet
Note: Use this worksheet only if you plan to itemize deductions, claim certain adjustments to income, or have a large amount of nonwage
income.
1
Enter an estimate of your 2018 itemized deductions. These include qualifying home mortgage interest,
charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 7.5% of
your income. See Pub. 505 for details . . . . . . . . . . . . . . . . . . . . . .
1
$
2 Enter:
{
$24,000 if you’re married filing jointly or qualifying widow(er)
$18,000 if you’re head of household
$12,000 if you’re single or married filing separately
}
........... 2
$
3 Subtract line 2 from line 1. If zero or less, enter “-0-” . . . . . . . . . . . . . . . . . 3
$
4 Enter an estimate of your 2018 adjustments to income and any additional standard deduction for age or
blindness (see Pub. 505 for information about these items) . . . . . . . . . . . . . . . .
4
$
5 Add lines 3 and 4 and enter the total . . . . . . . . . . . . . . . . . . . . . . 5
$
6 Enter an estimate of your 2018 nonwage income (such as dividends or interest) . . . . . . . . . 6
$
7 Subtract line 6 from line 5. If zero, enter “-0-”. If less than zero, enter the amount in parentheses . . . 7
$
8 Divide the amount on line 7 by $4,150 and enter the result here. If a negative amount, enter in parentheses.
Drop any fraction . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
9 Enter the number from the Personal Allowances Worksheet, line H above . . . . . . . . . . 9
10
Add lines 8 and 9 and enter the total here. If zero or less, enter “-0-”. If you plan to use the Two-Earners/
Multiple Jobs Worksheet, also enter this total on line 1, page 4. Otherwise, stop here and enter this total
on Form W-4, line 5, page 1 . . . . . . . . . . . . . . . . . . . . . . . . .
10
Form W-4 (2018)
Page 4
Two-Earners/Multiple Jobs Worksheet
Note: Use this worksheet only if the instructions under line H from the Personal Allowances Worksheet direct you here.
1
Enter the number from the Personal Allowances Worksheet, line H, page 3 (or, if you used the
Deductions, Adjustments, and Additional Income Worksheet on page 3, the number from line 10 of that
worksheet) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2
Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if you’re
married filing jointly and wages from the highest paying job are $75,000 or less and the combined wages for
you and your spouse are $107,000 or less, don’t enter more than “3” .............
2
3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter “-0-”)
and on Form W-4, line 5, page 1. Do not use the rest of this worksheet . . . . . . . . . . . .
3
Note: If line 1 is less than line 2, enter “-0-” on Form W-4, line 5, page 1. Complete lines 4 through 9 below to
figure the additional withholding amount necessary to avoid a year-end tax bill.
4 Enter the number from line 2 of this worksheet . . . . . . . . . . . 4
5 Enter the number from line 1 of this worksheet . . . . . . . . . . . 5
6 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . . 7
$
8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed . . . 8
$
9
Divide line 8 by the number of pay periods remaining in 2018. For example, divide by 18 if you’re paid every
2 weeks and you complete this form on a date in late April when there are 18 pay periods remaining in
2018. Enter the result here and on Form W-4, line 6, page 1. This is the additional amount to be withheld
from each paycheck . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
$
Table 1
Married Filing Jointly
If wages from LOWEST
paying job are—
Enter on
line 2 above
$0 - $
5,000
0
5,001
-
9,500
1
9,501
-
19,000
2
19,001
-
26,500
3
26,501
-
37,000
4
37,001
-
43,500
5
43,501
-
55,000
6
55,001
-
60,000
7
60,001
-
70,000
8
70,001
-
75,000
9
75,001
- 85
,000
10
85,001
-
95,000
11
95,001
-
130,000
12
130,001
-
150,000
13
150,001
-
160,000
14
160,001
-
170,000
15
170,001
-
180,000
16
180,001
-
190,000
17
190,001
-
200,000
18
200,001
and over
19
All Others
If wages from LOWEST
paying job are—
Enter on
line 2 above
$0 - $
7,000
0
7,001
-
12,500
1
12,501
-
24,500
2
24,501
-
31,500
3
31,501
-
39,000
4
39,001
-
55,000
5
55,001
-
70,000
6
70,001
-
85,000
7
85,001
-
90,000
8
90,001
-
100,000
9
100,001
-
105,000
10
105,001
-
115,000
11
115,001
-
120,000
12
120,001
-
130,000
13
130,001
-
145,000
14
145,001
-
155,000
15
155,001
-
185,000
16
185,001
and over
17
Table 2
Married Filing Jointly
If wages from HIGHEST
paying job are—
Enter on
line 7 above
$0
-
$24,375 $420
24,376 - 82,725 500
82,726 - 170,325 910
170,326 - 320,325 1,000
320,326 - 405,325 1,330
405,326 - 605,325 1,450
605,326 and over 1,540
All Others
If wages from HIGHEST
paying job are—
Enter on
line 7 above
$0 -
$7,000 $420
7,001 -
36,175 500
36,176 - 79,975 910
79,976 - 154,975 1,000
154,976 - 197,475 1,330
197,476 - 497,475 1,450
497,476 and over 1,540
Privacy Act and Paperwork Reduction
Act Notice. We ask for the information on
this form to carry out the Internal Revenue
laws of the United States. Internal Revenue
Code sections 3402(f)(2) and 6109 and
their regulations require you to provide this
information; your employer uses it to
determine your federal income tax
withholding. Failure to provide a properly
completed form will result in your being
treated as a single person who claims no
withholding allowances; providing
fraudulent information may subject you to
penalties. Routine uses of this information
include giving it to the Department of
Justice for civil and criminal litigation; to
cities, states, the District of Columbia, and
U.S. commonwealths and possessions for
use in administering their tax laws; and to
the Department of Health and Human
Services for use in the National Directory of
New Hires. We may also disclose this
information to other countries under a tax
treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to
federal law enforcement and intelligence
agencies to combat terrorism.
You aren’t required to provide the
information requested on a form that’s
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by Code section
6103.
The average time and expenses required
to complete and file this form will vary
depending on individual circumstances.
For estimated averages, see the
instructions for your income tax return.
If you have suggestions for making this
form simpler, we would be happy to hear
from you. See the instructions for your
income tax return.
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Form I-9 07/17/17 N
Page 1 of 3
ŹSTART HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically,
during completion of this form.
Employers are liable for errors in the completion of this form.
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which
document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ
an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later
than the first day of employment, but not before accepting a job offer.)
Last Name (Family Name) First Name (Given Name)
Middle Initial
Other Last Names Used (if any)
Address (Street Number and Name)
Apt. Number City or Town
State
ZIP Code
Date of Birth (mm/dd/yyyy)
U.S. Social Security Number
-
-
Employee's E-mail Address
Employee's Telephone Number
I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in
connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes):
1. A citizen of the United States
2. A noncitizen national of the United States (See instructions)
3. A lawful permanent resident
4. An alien authorized to work until
(See instructions)
(expiration date, if applicable, mm/dd/yyyy):
(Alien Registration Number/USCIS Number):
Some aliens may write "N/A" in the expiration date field.
Aliens authorized to work must provide only one of the following document numbers to complete Form I-9:
An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.
1. Alien Registration Number/USCIS Number:
2. Form I-94 Admission Number:
3. Foreign Passport Number:
Country of Issuance:
OR
OR
QR Code - Section 1
Do Not Write In This Space
Signature of Employee
Today's Date (mm/dd/yyyy)
Preparer and/or Translator Certification (check one):
I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.
(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my
knowledge the information is true and correct.
Signature of Preparer or Translator
Today's Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name)
Address (Street Number and Name)
City or Town
State
ZIP Code
Employer Completes Next Page
Form I-9 07/17/17 N
Page 2 of 3
USCIS
Form I-9
OMB No. 1615-0047
Expires 08/31/2019
Employment Eligibility Verification
Department of Homeland Security
U.S. Citizenship and Immigration Services
Section 2. Employer or Authorized Representative Review and Verification
(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You
must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists
of Acceptable Documents.")
Last Name (Family Name) M.I.First Name (Given Name)
Employee Info from Section 1
Citizenship/Immigration Status
List A
Identity and Employment Authorization
Identity
Employment Authorization
OR List B AND List C
Additional Information
QR Code - Sections 2 & 3
Do Not Write In This Space
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Document Title
Issuing Authority
Document Number
Expiration Date (if any)(mm/dd/yyyy)
Certification: I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee,
(2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the
employee is authorized to work in the United States.
The employee's first day of employment (mm/dd/yyyy):
(See instructions for exemptions)
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Title of Employer or Authorized Representative
Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative
Employer's Business or Organization Name
Employer's Business or Organization Address (Street Number and Name)
City or Town
State
ZIP Code
Section 3. Reverification and Rehires (To be completed and signed by employer or authorized representative.)
A. New Name (if applicable)
Last Name (Family Name)
First Name (Given Name) Middle Initial
B. Date of Rehire (if applicable)
Date (mm/dd/yyyy)
Document Title Document Number
Expiration Date (if any) (mm/dd/yyyy)
C. If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes
continuing employment authorization in the space provided below.
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if
the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.
Signature of Employer or Authorized Representative
Today's Date (mm/dd/yyyy)
Name of Employer or Authorized Representative
LISTS OF ACCEPTABLE DOCUMENTS
All documents must be UNEXPIRED
Employees may present one selection from List A
or a combination of one selection from List B and one selection from List C.
LIST A
2. Permanent Resident Card or Alien
Registration Receipt Card (Form I-551)
1. U.S. Passport or U.S. Passport Card
3. Foreign passport that contains a
temporary I-551 stamp or temporary
I-551 printed notation on a machine-
readable immigrant visa
4. Employment Authorization Document
that contains a photograph (Form
I-766)
5. For a nonimmigrant alien authorized
to work for a specific employer
because of his or her status:
Documents that Establish
Both Identity and
Employment Authorization
6. Passport from the Federated States of
Micronesia (FSM) or the Republic of
the Marshall Islands (RMI) with Form
I-94 or Form I-94A indicating
nonimmigrant admission under the
Compact of Free Association Between
the United States and the FSM or RMI
b. Form I-94 or Form I-94A that has
the following:
(1) The same name as the passport;
and
(2) An endorsement of the alien's
nonimmigrant status as long as
that period of endorsement has
not yet expired and the
proposed employment is not in
conflict with any restrictions or
limitations identified on the form.
a. Foreign passport; and
For persons under age 18 who are
unable to present a document
listed above:
1. Driver's license or ID card issued by a
State or outlying possession of the
United States provided it contains a
photograph or information such as
name, date of birth, gender, height, eye
color, and address
9. Driver's license issued by a Canadian
government authority
3. School ID card with a photograph
6. Military dependent's ID card
7. U.S. Coast Guard Merchant Mariner
Card
8. Native American tribal document
10. School record or report card
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
2. ID card issued by federal, state or local
government agencies or entities,
provided it contains a photograph or
information such as name, date of birth,
gender, height, eye color, and address
4. Voter's registration card
5. U.S. Military card or draft record
Documents that Establish
Identity
LIST B
OR AND
LIST C
7. Employment authorization
document issued by the
Department of Homeland Security
1. A Social Security Account Number
card, unless the card
includes one of
the following restrictions:
2. Certification of report of birth issued
by the Department of State (Forms
DS-1350, FS-545, FS-240)
3. Original or certified copy of birth
certificate issued by a State,
county, municipal authority, or
territory of the United States
bearing an official seal
4. Native American tribal document
6. Identification Card for Use of
Resident Citizen in the United
States (Form I-179)
Documents that Establish
Employment Authorization
5. U.S. Citizen ID Card (Form I-197)
(2) VALID FOR WORK ONLY WITH
INS AUTHORIZATION
(3) VALID FOR WORK ONLY WITH
DHS AUTHORIZATION
(1) NOT VALID FOR EMPLOYMENT
Page 3 of 3
Form I-9 07/17/17 N
Examples of many of these documents appear in Part 13 of the Handbook for Employers (M-274).
Refer to the instructions for more information about acceptable receipts.
This form cannot be used for employees hired prior to September 6, 2012.
This mandatory affirmation is provided by the Colorado Division of Labor. Visit www.colorado.gov/cdle/evr for more information.
Revision Date: 09/06/12
Expiration Date: 10/01/14
Affirmation of Legal Work Status
Pursuant to § 8-2-122, Colorado Revised Statutes
Employee Name: _______________________________________________ __________
Last First Middle Date of Birth
Social Security Number: ______-_______-______ Date of Hire: (MM/DD/YYYY)
In accordance with § 8-2-122, C.R.S., within 20 days after hiring the new employee listed above,
I affirm all four of the following by signing this form:
1. I have examined the legal work status of the above named employee.
2. I have retained file copies of the documents required by 8 U.S.C. sec. 1324a.
3. I have not altered or falsified the employee’s identification documents.
4. I have not knowingly hired an unauthorized alien.
____________________________________________ ______________________________
Print Name of Employer (or Designated Representative) Official Title
____________________________________________ _________________
(MM/DD/YYYY)
Signature of Employer (or Designated Representative) Date Signed by Employer
____________________________________________ ______________________________
Business or Organization Name Employer Phone Number
The provision of false or fraudulent information on this form may subject the employer to a
significant fine and/or additional penalties.
This form and the documents required by 8 U.S.C. sec. 1324 (copies or electronic copies) will be
retained for the duration of the above named individual’s employment.
§ 8-2-122(2), C.R.S.: On and after January 1, 2007, within twenty days after hiring a new employee, each employer in Colorado
shall affirm that the employer has examined the legal work status of such newly-hired employee and has retained file copies of
the documents required by 8 U.S.C. sec. 1324a; that the employer has not altered or falsified the employee’s identification
documents; and that the employer has not knowingly hired an unauthorized alien. The employer shall keep a written or electronic
copy of the affirmation, and of the documents required by 8 U.S.C. sec. 1324a, for the term of employment of each employee.
1430 E Missouri Ave Suite B155-Phoenix, AZ
85014 – Phone (602) 778-9856 – Fax (602) 778-9857
www.sunwestes.com
SUNWEST EMPLOYER SERVICES INC.
EMPLOYEE AUTHORIZ
ATION AGREEMENT FOR DIRECT DEPOSIT
I hereby authorize and request Sunwest Employer Services Inc., herein SUNWEST, to make payment of any amounts owed to me by initiating credit entries
to my account indicated below in the bank(s) named below, herein BANK, and I authorize and request BANK to accept any credit entries initiated by
SUNWEST to such account and credit the same to such account without responsibility for the correctness thereof.
I also authorize and request SUNWEST to effect repayment to SUNWEST for amounts owed it because of a prior erroneous credit initiated to my account,
if prior to the initiation of the correction entry SUNWEST has sent or delivered to me written notice of the correction, and the reason therefore, and the
correcting entry is transmitted in such time as to be delivered, or make available to BANK before midnight of the tenth day following settlement for the
erroneous entry.
It is understood that this agreement may be terminated by me at any time by written notification to SUNWEST. Any notification to SUNWEST shall be
effective only with respect to entries initiated by SUNWEST after receipt of such notification and a reasonable opportunity to act on it.
I recognize, acknowledge and accept that this service is being provided for my convenience. As such, I agree to hold SUNWEST, each participating bank,
and NACHA harmless from any claim incident to the operation of this plan arising from any act or omission by SUNWEST including, without limitation,
and claim based on alleged loss as a result of non-credit of any deposit, and any claim which may be made by me as a result of the rejection of any debits
because of insufficient funds arising from the failure to credit deposits to my account. I further understand that should I change, or close the account given
to SUNWEST and fail to notify SUNWEST in writing prior to the initiation of the credit, I will be charged a bank fee of no less than $15.00 to reprocess the
payment owed to me. In addition, I understand that direct deposit should take effect the second pay period after submitting this authorization. I understand
and recognize that it is ultimately my responsibility to verify if I have received either a regular “live” check or direct deposit.
C
ompany Name
Soci
al Security Number _____-_____-_____ Employee Name
P
lease Print Name
I do not elect direct deposit or I wish to cancel all my direct deposits (Check Here and Sign Below)
I authorize direct deposit into the following accounts ONLY (any previous form(s) submitted will be void)
Financial Institution/Account Number(s):
Account 1. _____________________ Checking Savings Amount or % Deposited: __________ Routing Number: ____________________
Account 2. _____________________ Checking
Savings Amount or % Deposited: __________ Routing Number: ____________________
Account 3. _____________________ Checking
Savings Amount or % Deposited: __________ Routing Number: ____________________
Account 4. _____________________ Checking
Savings Amount or % Deposited: __________ Routing Number: ____________________
Em
ployee Signature
Date______/______/______
m
m/dd/yy
ATTACH VOIDED CHECK(s) HERE:
V O I D E D C H E C K(s)
1
430 E Missouri Ave Suite B155-Phoenix, AZ 85014- Phone (602)778-9856- Fax (602)-778-9857
www.sunwestes.com
ON-THE-JOB INJURY INCIDENT PROCEDURES
Please keep this form for your personal records. This form defines your responsibilities in the event you are injured on-the-job.
If an injury occurs on-the-job during designated working hours, assess the injury and provide first aid whenever possible. The employee
is responsible for notifying their Supervisor immediately
before leaving work for the day.
If the injury is life threatening
, proceed to the nearest emergency room. Please provide the emergency room staff with the name of your
worksite employer including the name of Sunwest (i.e. ACE Construction/Sunwest Employer Services). In addition, please provide the
following Workers’ Compensation Contact Information to the emergency room staff:
WORKERS’ COMPENSATION CONTACT INFORMATION
If medical attention is required beyond first aid but not life threatening, employees must seek initial treatment at the nearest Concentra
Medical Clinic (Concentra). Please provide the Concentra Staff with the Workers’ Compensation Contact Information listed above. Your
worksite employer should have a list of Concentra locations available for you to review.
If a Concentra location is not available in your city or state, please seek treatment at the closest urgent care facility.
Employees are required to submit to a post-injury drug and alcohol test within 24-hours of notification of injury on all injuries
treated at a facility.
If an employee fails to pass, refuses to cooperate with, or refuses to take the post-injury drug test, disciplinary action may be taken up to
and including termination of employment.
The supervisor must immediately notify Sunwest at the time of injury or within 24-hours. If the supervisor is unavailable, the employee
must report the injury immediately to Sunwest within 24-hours at the Workers’ Compensation Contact Information listed above.
The supervisor and employee must complete the Client Report of Injury/Illness Form which is located on the Sunwest website, at
www.sunwestes.com
and fax the form to Connie Dixon at 602-386-3575. Please note that you must fax this information within 24
hours of the injury.
For all questions regarding work related injuries, contact Connie Dixon at the contact numbers listed above.
SUNWEST CONTACT: CONNIE DIXON
PHONE NUMBER: 602-386-3544
T
OLL FREE: 888-284-3734 EXT
: 280
FAX
NUMBER:
602-386-3575
1430 E Missouri Ave Suite B155-Phoenix, AZ 85014- Phone (602)778-9856- Fax (602)-778-9857
www.sunwestes.com
EMPLOYER REQUEST FOR DISCLOSURE OF WAGE ASSIGNMENT ORDER TO
PROVIDE CHILD SUPPORT
Ari
zona Revised Statute 23-722.02, states that after an employee is hired, rehired or returns from an unpaid leave of absence, the employer
shall request that the employee disclose whether the employee is subject to a wage assignment order to provide child support. If the
employee is subject to a wage assignment order to provide child support, they shall provide a copy of the order of assignment to the employer.
In accordance with the foregoing statute, Sunwest Employer Services, Inc. (Sunwest) requests that every employee disclose whether they are
subject to a wage assignment to provide child support. If an employee has multiple orders, the employee shall provide Sunwest with a copy of
each order. On the disclosure of an obligation to pay child support along with a copy of the order, Sunwest shall begin withholding the
support payments according to the terms of the order. An employee who is ordered to pay child support and who fails to comply with this
request is guilty of a class 3 misdemeanor.
Are you subject to a wage assignment order to provide child support? Yes _____ If yes, please attach a copy of the order of assignment
No _____
By signing this request, I certify that the information presented in this request is true and accurate.
_____________________________________________________________
____________________________
E
mployee Signature
D
ate
_____________________________________________________________
Employee Name (Printed)
_____________________________________________________________
Name of Work-Site Employer
SUNWEST EMPLOYER SERVICES INC.
DESIGNATION OF BENEFICIARY AND CONTINGENT BENEFICIARY(IES)
Basic Term Life Insurance through Humana is a benefit provided by Sunwest (at no charge) to all full-time
employees. This benefit becomes effective first of the month following 60 days of full-time employment with
Sunwest. Sunwest considers full-time employment as working 30 hours per week.
Humana Group Policy: #547722 Insured employee’s social s
ecurity number:____________________________
Primary Beneficiary Designation
FULL NAME (Last, First, Middle Initial) RELATIONSHIP DATE OF BIRTH ADDRESS (Street, City, State, Zip) SHARE%
Payment will be made in equal shares or all to the survivor unless otherwise indicated. Total share designation must equal 100%
In the event said pr
imary beneficiary(ies) predecease(s) the insured, I designate as contingent beneficiary(ies) below:
Contingent Beneficiary Designation
FULL NAME (Last, First, Middle Initial) RELATIONSHIP DATE OF BIRTH ADDRESS (Street, City, State, Zip) SHARE%
Payment will be made in equal shares or all to the survivor unless otherwise indicated. Total share designation must equal 100%
If no primary
or contingent beneficiary designated shall be living following the insured’s death, the amount payable
by reason of the insured’s death shall be payable as provided in the Group Policy.
I, the insured, reserve the right to change this designation at any time.
This designation becomes effective upon receipt by the Benefits Department at Sunwest Employer Services.
Name and address of Insured or Owner (if assigned). (Please print)
_____________________________________________________________________ __________________________________
Signature of Insured of Owner (if assigned) Date Signed
_____________________________________________________________________
Please print your full name for clarification purposes
Please do not elect yourself as a beneficiary. Life benefits are paid out upon the death of the “covered
employee”. Without a beneficiary elected, the life benefit cannot be paid out.
Pl
ease note – Do not erase or attempt to make any corrections, please utilize a new form for changes and/or corrections.
When the beneficiary is not related to you by blood or marriage, the “Relationship” designation should read “Nonrelative”.
ColoradoDivisionofLabor
63317thStreet,Suite200•Denver,CO80202‐3611•(303)318‐8441•www.colorado.gov/cdle/evr
RevisionDate:09/01/14
ExpirationDate:10/01/17
ColoradoAffirmationFormInstructions
EmploymentVerificationLaw,§8‐2‐122,C.R.S.
OverviewoftheColoradoEmploymentVerificationLaw
TheemploymentverificationlawappliestoallpublicandprivateemployersinColorado,andisin
additiontoseparatefederalFormI‐9requirements.Employersmustcomplywiththeprovisionsofthe
lawforallColoradoemployeeshiredonorafterJanuary1,2007.Therearetwomainrequirements,
bothofwhichmustoccurwithin20calendardaysofhire:(1)anaffirmationrequirement,and(2)a
requirementtomakeandretaincopiesofemployeeidentityandemploymentauthorization
documentation(copiesoftheemployee’sidentityandemploymentauthorizationdocumentswhich
werepresentedforcompletionoftheFormI‐9).Visitwww.colorado.gov/cdle/evrformoreinformation.
CompletionoftheAffirmationForm
1. TheattachedaffirmationformisdesignedforusebyColoradoemployers.Bysigningtheform,the
employeraffirmstoallfouroftheemploymenteligibilitycomponentsfortheemployeelisted.
2. TheemployermusthavecompletedanaffirmationformforallColoradoemployeeshiredonorafter
January1,2007.
3. EffectiveOctober1,2014,ColoradoemployersmustusetheDivisionaffirmationformwitharevision
dateof09/01/14.
a. The09/01/14versionoftheformmustbeusedforallColoradoemployeeshiredbetween
October1,2014andOctober1,2017.
b. The09/01/14versionoftheformcannotbeusedforColoradoemployeeshiredpriorto
September1,2014.
4. Theformmustbecompletedwithin20calendardaysafterhiringeachemployee.Reviewthe
informationbelowifyouhavenotadheredtothisrequirement.
5. Theemployer,nottheemployee,isresponsibleforfillingoutandcompletingtheforminatimely
fashion.Theformmaybecompletedbytheemployer’sdesigneeorrepresentative.
6. Thefollowingitemsontheformmustbelegiblycompletedbytheemployer.Theemployermaynot
leaveanyoftheseitemsblankorincomplete:
a. Employeenameanddateofhire(Month/Day/Year).
b. Employername,signature,anddateofemployersignature(Month/Day/Year).
ColoradoDivisionofLabor
63317thStreet,Suite200•Denver,CO80202‐3611•(303)318‐8441•www.colorado.gov/cdle/evr
RetentionoftheAffirmationForm
Formsmustberetainedbytheemployerforthedurationoftheemployee’semployment.Theemployer
mustproducecopiesoftheformtotheColoradoDivisionofLaboruponrequest,butdoesnothaveto
submitformsabsentarequest.
FailuretoProperlyCompletetheAffirmationFormorWorkEligibilityDocumentationRequirements
Theemployermustprovideaccurateandcompleteinformationontheform.Provisionoffalseor
fraudulentinformationontheformmaysubjecttheemployertoasignificantfineand/oradditional
penalties.
Iftheemployerhasnotproperlycompletedtheaffirmationformwithin20calendardaysofhiringthe
employee,ortheemployerhasnotmadeandretainedcopiesofemployeeidentityandemployment
authorizationdocumentationwithin20calendardaysofhiringtheemployee:
1. DONOTcompleteanaffirmationformfortheaffectedemployee(s).Theemployercannotcomplete
avalidformoncethe20calendardayshaveelapsedsincehire.

2. DONOTbackdateorotherwiseenterincorrectinformationontotheformfortheaffected
employee(s).Theemployermustnotenterfalseorfraudulentinformationontotheform.
3. DONOTattempttomakeandretaincopiesofemployeeidentityandemploymentauthorization
documentationifyoudidnotcomplywiththisrequirementwithin20calendardaysofhiringthe
employee.Seekingsuchdocumentationafterthe20calendardayshaveelapseddoesnotcomply
withColoradolaw,andmayalsoviolateseparatefederalimmigrationlaws.
DOcomplywiththeemploymentverificationlawforallnewhiresgoingforward.Theemployermust:
(1)properlycompleteaffirmations,and(2)makeandretaincopiesofemployeeidentityand
employmentauthorizationdocumentation,within20calendardaysofhireforallemployeeshiredafter
thediscoveryofthehistoricalnoncompliance.
Followingthestepsabove,andengaginginotherappropriatecompliance
actions,mayreducethe
likelihoodofafine,ormaymitigatethevalueofafine,dependinguponthecircumstances.Consultwith
anattorneyforlegaladvice.

This form cannot be used for employees hired prior to September 1, 2014.
This mandatory affirmation is provided by the Colorado Division of Labor. Visit www.colorado.gov/cdle/evr for more information.
Revision Date: 09/01/14
Expiration Date: 10/01/17
Affirmation of Legal Work Status
Pursuant to § 8-2-122, Colorado Revised Statutes
Employee Name: _______________________________________________ __________
Last First Middle Date of Birth
Social Security Number: ___________________ Date of Hire: (MM/DD/YYYY)
In accordance with § 8-2-122, C.R.S., within 20 calendar days after hiring the new employee
listed above,
I affirm all four of the following by signing this form:
1. I have examined the legal work status of the above named employee.
2. I have retained file copies of the documents required by 8 U.S.C. sec. 1324a.
3. I have not altered or falsified the employee’s identification documents.
4. I have not knowingly hired an unauthorized alien.
____________________________________________ ______________________________
Print Name of Employer (or Designated Representative) Official Title
____________________________________________ _________________(MM/DD/YYYY)
Signature of Employer (or Designated Representative) Date Signed by Employer
____________________________________________ ______________________________
Business or Organization Name Employer Phone Number
The provision of false or fraudulent information on this form may subject the employer to a
significant fine and/or additional penalties.
This form and the documents required by 8 U.S.C. sec. 1324 (copies or electronic copies) will be
retained for the duration of the above named individual’s employment.
§ 8-2-122(2), C.R.S.: On and after January 1, 2007, within twenty days after hiring a new employee, each employer in Colorado
shall affirm that the employer has examined the legal work status of such newly-hired employee and has retained file copies of
the documents required by 8 U.S.C. sec. 1324a; that the employer has not altered or falsified the employee’s identification
documents; and that the employer has not knowingly hired an unauthorized alien. The employer shall keep a written or electronic
copy of the affirmation, and of the documents required by 8 U.S.C. sec. 1324a, for the term of employment of each employee.
COACH HOLDINGS, INC.
MEDICAL INSURANCE
DENTAL INSURANCE
VISION INSURANCE
If you have any interest in these plans, you must contact Stacy Ellis at 602-386-3550 or
you can fax this election form with your information on it.
This form must be submitted whether you want benefits or are declining benefits. This
form can be faxed to 602-386-3581 or emailed to SEllis@sunwestinsurance.com
I am interest in Medical________________
I am interest in Dental _________________
I am interested in Vision _______________
I am NOT interested in any of these benefits _______________
Name______________________________________________________
Email address _______________________________________________
Phone Number ______________________________________________
To properly assure coverage, we will need this information as soon as possible from your
hire date.
SunwestEmployerServicesInc.-3707N7
th
Street,Suite#300-Phoenix,AZ85014P:602‐778‐9856F:602‐778‐9857
Sunwest Online
Sunwestonlineallowsemployeestoaccesstheirpayroll
InformationontheInternet.Theycanviewtheircheck
amounts,vacationaccruals,payrolldeductions,yeartodate
totalsandmore.
How to use Sunwest Online
IfyouareanewusertoSunwestOnlineyoumustfirstcreateauserIDand
password.
GototheSunwestwebsiteatwww.sunwestes.com
Click onclientloginatthe toprightcornerofthescreen.Youwillbepresented
withasecureloginscreen.
Selectthenewuserbutton.
Enteryoursocialsecuritynumber(xxxxxxxxx),employeenumber(your
employeenumberisan11digitnumberloc
atedonyourpaycheckjustbefore
thedate.)andbirthdate(mm/dd/yy).
Youwillnow bepromptedtoenter:auserIDofatleast6characters,a
passwordofatleast6characters,andyouremailaddress.Donothitenteruntil
youhavecompletedallfields.
**When selecting a user ID and password, it is best not to use common words.
Addinganumbertoyourpasswordwillhelpmakeitmore secure. User ID’s and
passwordsarenotcasesensitive.
Sunwesthasmadeeveryefforttoprotectyourpersonalinformation.Verysensitive
informationlikeSocialSecuritynumbersandBankaccountinformationarenot
availableonline.AlldatatransmittedovertheInternetisencryptedandourservers
areprotectedbysophisticatedfirewalltechnologies.
EE ID
EMPLOYEE AUTHORIZATION AGREEMENT FOR EMAILING PAYCHECK STUB
I hereby authorize and request Sunwest Employer Services, Inc., herein "Sunwest", to email my paycheck stubs
to the email address that I provide below.
It is understood that this agreement may be terminated by me at any time by written notification to Sunwest. Any
notification to Sunwest shall be effective only with respect to entries initiated by Sunwest after receipt of such
notification and a reasonable opportunity to act on it.
WYo
ur orkplace Employer Name
Social Security Number _____-_____-_____
Employee Name
Please Print Name
I do not elect to have my paycheck stubs emailed to me (Check Here and Sign Below)
I authorize my paycheck stubs to be emailed to me to the following address ONLY (any previous form(s) submitted will be voided)
Email Address: ____________________
____________________________
Employ Siee gnature
Date_
_____/______/______
mm/dd/yy
143 0 E Missour i Ave, Suite B155, Pho enix, AZ
850 14 ( 602) 778- 9856 www.sunwestes.com
Please send forms back to the Payroll Department at Fax:602-778-9857 or Email: payroll@sunwestes.com
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COLORADO PEO NEW HIRE PACKET

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Completed 27 May 2021

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