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List of Tax Documents to Bring to your Appointment

Professional Employment Opportunity

Payroll Submission Form

Business Name:

*Required

Fax Number:

*Required

Email Address:

*Required

Send Report by:

Email:

Fax:

U.S. Mail:

*One required

Submitted By (name):

*Required

Employee Name:

*Required

Employee Hours Worked:

*Required

Employee Rate of Pay:

*Required

Gratuities Income: (Tips)

Work Period: (dd/mmyy)

Start Date:

Ending Date:

* Both required

Notes: