AUTOMATED PAYROLL SOLUTIONS, LLC
P.O. BOX 702
SIKESTON, MO.  63801
573-471-1983
                                          New Employee Payroll Information

   Employer:  _____________________________________________________

   Employee Name:  _______________________________________________

   Address: ______________________________________________________                

   City: _________________________ State: ______________ Zip: _________

   Social Security #:  ______  -  ____  -  ______       DOB: _____ / _____ / _____

   Date of Hire: _____ / _____ / _____                        __Male         __Female

   Rate of Pay: ______________        __Per hour   __Salary

   Department / Location: ___________________________________________

   

   Deduction / Garnishments

   Description:________________________ Amt:$_________ Freq:__________

   Description:________________________ Amt:$_________ Freq:__________

   Description:________________________ Amt:$_________ Freq:__________

   Description:________________________ Amt:$_________ Freq:__________


   Other Information : _______________________________________________

   ______________________________________________________________

   ______________________________________________________________

   ______________________________________________________________

  
  NOTE: In addition to this form submit copies of the federal form W-4 and
             State form W-4  If applicable also submit direct deposit form.