Fillable Employer In f o rma tion Client Information

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Employer In f o rma tion Client Information

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Employer
In
f
o
rma
tion
*Employer legal name
(IRS filing name)
Employer dba name
*FEIN
(If applied for, enter date applied)
Applied for date:
Will we have access to your current system for data extraction?
□ Yes □ No
Organization Type
□ Corp. □ S- Corp. □ LLC □ LLP □ PLC □ Sole Prop. □ Partnership □ Not for Profit
Authorized C
onta
c
ts
Information will not be released to or accepted from anyone not on this list
Contact Types:
1. Outside Accountant 2. Billing 3. Contract Signer 4. Finance 5. HR 6. HR/PR 7. Other 8. Payroll 9. Payroll Notification 10. Tax Filing
Access Levels:
CU (Client user)- Full access to HR & Payroll HRA (Client HR Admin) – Access to HR & Employee Records, No PR updates
CBA (Client Benefits Admin)- Access to EE Benefits CPE (Client Payroll entry only) –Access only to Payroll Time Entry
CGL (Client GL/labor only)- Access only to General Ledger and Labor components
*Primary Contact: First: Last:
Title:
Contact type:
(Enter # for all that apply)
Access levels:
(Enter code for all that apply)
Phone: Ext.
Fax:
Email:
Secondary contact: First: Last:
Title:
Contact type:
(Enter # for all that apply)
Access levels:
(Enter code for all that apply)
Phone: Ext.
Fax:
Email:
Additional contact: First: Last:
Title:
Contact type:
(Enter # for all that apply)
Access levels:
(Enter code for all that apply)
Phone: Ext.
Fax:
Email:
*Designates required fields
Client Information Form
Federal Tax
Info
rm
ation
*Type of filer:
□
941 Regular
□
944 Annual
□
943 Agricultural
*Federal withholding
payment frequency:
□
Next day □ Semiweekly □ Monthly
Tax
*Please list the address of each home and office location you have employees working at
Street Address C
ity
State ZIP County
Tax
Typ
e
(County, C
ity,
School Dist., e
t
c
)
# of
EEs
Tax
ID#
Tax
Rate
Payment Frequency
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
□ W □ SW □ M □ SM □ Q
State Tax
In
f
o
rm
ation
*State
(List ALL states taxes are paid in)
*Withholding
(SITW) Tax ID#
*Withholding Payment
Frequency
*Unemployment
(SUI) Tax ID#
*Unemployment Tax
Rate (%)
□ W □ SW □ M □ Q
□ W □ SW □ M □ Q
□ W □ SW □ M □ Q
□ W □ SW □ M □ Q
Tax Related Q
u
es
tions
What was the first payroll check date for the current year?
Will we be the sole payroll provider for all employees paid under this FEIN?
□ Yes □ No
Have you withheld payroll taxes in the current quarter for this FEIN?
(If yes, provide tax liability/filing documentation)
□ Yes □ No
Have you withheld payroll taxes in previous quarters this year for this FEIN?
(If yes, provide tax liability/filing documentation)
□ Yes □ No
Does your company currently incur payroll taxes under any other FEIN?
(If yes, list additional FEINS)
□ Yes □ No
List:
Has your company used any other FEIN in the current year?
(If yes, please list FEIN)
□ Yes □ No
List:
*Designates required fields
Client Information Form
Bank Account Information
Bank Account Information
*Routing number: *Routing number:
Bank name: Bank name:
*Account number: *Account number:
Check message:
(Void After 90 Days, etc)
Check message:
(Void After 90 Days, etc)
*Starting check #: *Starting check #:
Logo on check: Logo on check:
Imprint signature on
check:
□ Yes □ No
Imprint signature on
check:
□ Yes □ No
Payroll check type:
□ OBC □ Corporate
Payroll check type:
□ OBC □ Corporate
Use account for:
(Check all that apply)
□ Taxes □ Fees
□ Checks □ EE direct deposit
Use account for:
(Check all that apply)
□ Taxes □ Fees
□ Checks □ EE direct deposit
Check
In
form
ation
*Name to be printed on checks (can choose both):
□ Legal name □ DBA
*Address to be printed on checks (select one):
□ Mailing address □ Delivery address
Print department and division #s on checks:
□ Yes □ No
Phone # to be printed on checks:
Message to be printed on checks:
(i.e., Void After 90 Days)
Deduction C
o
de
s
Please check all deduction codes that apply, add any additional custom codes below:
□ Medical □ Pre-tax □ Post-tax
□ Vision □ Pre-tax □ Post-tax
□ Dental □ Pre-tax □ Post-tax
□ FSA □ Medical □Dependent Care □ Transit
□ HSA □ Pre-tax □ Post-tax
□ Voluntary Life □ Employee □ Spouse □Child
□ Short-term Disability □ Pre-tax □ Post-tax
□ Long-term Disability
□ Advance
Other Deduction Codes Description Taxability
□ Pre-tax □ Post-tax
□ Pre-tax □ Post-tax
□ Pre-tax □ Post-tax
□ Pre-tax □ Post-tax
*Designates required fields
Pre-tax Post-tax
Client Information Form
Deferred C
o
mpen
sation
Please check all that apply
□ 401(k) Roth □ 401(k) □401(k) Loan □ 401(k) Simple
□ 403(b) □ 403(b) Roth
□408(k) SARSEP
□ 408(p) Simple IRA
□ 457(b) Deferred Comp □ 457(b) Roth
Other:(Please list)
Company match:
□ Yes □No If yes, would you like us to track it? □ Yes □No
Group Term
Li
fe
Group Term Life:
□ Yes □No
Paid Time Off
Do you have PTO?
□ Yes □No
Would you like us to track your PTO?
(If yes, provide a summary of your PTO policies)
□ Yes □No
Workers C
o
mpe
nsation
Do you have Workers’ Compensation?
□ Yes □No
Would you like us to track your Workers’ Compensation?
(If yes, provide the Worker Comp policy including the codes and
r
a
tes
)
*If yes, provide all valid work class code with every employee
c
od
e
d
□ Yes* □No
General
Led
ger
Do you have a General Ledger?
□ Yes □No
Will you need a General Ledger set up in iSolved?
(If yes, provide the General Ledger Chart of Accounts and Report of Current GL Entries)
□ Yes □No
Time and
Atte
ndanc
e
Do you have a Time and Attendance Provider?
(If yes, provide the name of your current provider)
□ Yes □No
Name:
Delivery
Info
rm
ation
*Delivery (physical address):
Street:
City: State: ZIP:
*Designates required fields
Client Information Form
Earning C
o
de
s
*Please check all earning codes that apply, add any additional custom codes below:
□ Regular □ Salary □ 1099 □ Commission □ Bonus □ Vacation
Additional Earning
Codes
Description Taxability
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
Fringe
B
enef
its
*Please check all fringe benefits codes that apply, add any additional custom codes below:
Additional Fringe
Benefits Codes
Description Taxability
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
□ Taxable □ Nontaxable
□
Paid □ Nonpaid
Payroll Processing
Info
rm
ation
*Payroll Frequency:
□ Weekly □ Biweekly □ Semimonthly □ Monthly
First pay period start date:
First payroll check date:
Second pay period start date:
Second payroll check date:
*If a check date falls on Saturday, date checks on:
□ Friday □Monday
*If check date falls on Sunday, date checks on:
□ Friday □Monday
*If check date falls on a holiday, date checks:
□ Previous day □ Next day
Additional
No
te
s
*Designates required fields
Client Information Form
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Employer In f o rma tion Client Information

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Completed 3 May 2021

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