Employee Change/Term

Enter Hotel ID or Full Name

Enter Employees LAST Day Worked ONLY

Enter SS#

Enter Date of Birth MM/DD/YY

Enter the Employee Home Address including City, State and Zip Code

Cell Phone Only

Employee 1st day of work

Enter hourly rate. If the employee has two pay rates, write the details here, including if it is a different department code.

Fill in from W-4, Box 3

Enter additional amount

Enter Standard deduction (1,2,3......)

Fill in any extra deduction amount