Page 24 - Payroll & Paycom_8-22-17_PRISMA_Neat

FORMS

PIF (Personal Information Form)

When is this form used? Personal Information Form
Personal

______________________________ _______________________ _____

First Name

MI
• New hire (part of the new hire packet; subsequent Social Security Number: _____-____-_______

Last Name

Gender:  Male  Female
SAMPLE
changes made by employee through Paycom ESS) . Date of Birth (mm/dd/yyyy): _________________ State ______________
Place of Birth: _______________________ ___________

Country

City
Address/Phone/Email

______________________________________________________________

Street Address

______________________________ __________
___________

City

Zip Code

State

_______________________

Phone Number(s): _________________
Email Address: __________________________________________________

Emergency Contact
Relationship: _______________________
Daytime Phone: _________________
Emergency Contact Person: ____________________________________
Evening Phone: ______________

Race/Ethnicity (Voluntary)
 Hispanic or Latino  White  Black or African American
 Native Hawaiian or Other Pacific Islander  Asian
 American Indian or Alaska Native  Two or More Races
Revised: January 20, 2015

Form W-4
When is this form used?
• New hire (part of new hire packet) *Note:
When a new hire is completing the form W-4,
he/she is to be reminded to read the instructions and
complete the worksheet that accompanies the
form . This will assist in understanding how to properly
claim allowances or exemptions, especially the
section in the upper left hand corner regarding
claiming an exempt status .
• When changing marital status or exemptions (this can
be done at any time the employee wishes through
Paycom ESS) .
State Income Tax Withholding Form
(if applicable)
When is this form used?
• New hire (part of new hire packet) *Note: When a
new hire is completing the form State Tax Form,
he/she is to be reminded to read the instructions and SAMPLE
complete the worksheet that accompanies the
form . This will assist in understanding how to properly
claim allowances or exemptions .
• When changing marital status or exemptions (this can
be done at any time the employee wishes through
Paycom ESS) .
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Revised November 2016 23 PAYROLL