Employee informationSSN* Employee ID Company ID Name* Last Name First Name MI Address* Address 1 Address 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of birth* MM slash DD slash YYYY Gender Department Current hire date MM slash DD slash YYYY Termination date MM slash DD slash YYYY Current status code Active Terminated Inactive Position status (for timeclock import) Full Time Part Time Salary amount Hourly rate 1 Hourly rate 2 Pay frequency Weekly Bi-Weekly Semi-Monthly Monthly Other Workers' comp code Tax withholding statusFederal marital status* Single Married Married, but withholding at Single rate Federal exemptions*Number: Federal Withholdings Flat rate Additional Amount Percentage State Withholdings Flat rate Additional Amount Percentage State marital status Single Married Married, but withholding at Single rate State exemptionsNumber: SIT/SDI state SUI state Local tax / county Recurring earnings/deductions(Per pay period, in addition to standard tax deductions)Description Select one: Pre-tax Post-tax Amount Percentage Description Select one: Pre-tax Post-tax Amount Percentage Time off balance(If you want Wells Fargo Business Payroll Services to track time off balances)Description Balance Description Balance Direct deposit information(It can take one to two payroll periods for you to begin receiving direct deposits.)Bank name Account type Checking Savings Amount Percentage Routing/transit number(must start with 0, 1, 2 or 3) Account number NameThis field is for validation purposes and should be left unchanged. Δ
