Bilingual Payroll Form

Bilingual Payroll Form

Purpose: This form collects the employee payroll and tax election information and language preference for payroll communications. Datos en inglés y español se proporcionan para su conveniencia; si existe alguna discrepancia, comuníquese con Recursos Humanos.

Personal Information / Información Personal

Employee Name:

Social Security Number / Tax ID:

English Español Other:

Position and Pay Details / Puesto y Pago

Date of Hire / Fecha de inicio:

Exempt from Overtime: Yes    No

Direct Deposit Authorization / Autorización de Depósito Directo

I authorize the Employer to initiate deposit entries to my account at the financial institution named below and, if necessary, to initiate adjustments for any erroneous deposits. Yo autorizo al empleador a depositar mi pago en la cuenta indicada.

Account Type: Checking Savings

Tax Withholding Elections / Elecciones de Retención

Federal Filing Status / Estado civil tributario federal: Single Married Head of Household

Federal Allowances / Dependents claimed:    Additional Withholding: $

Payroll Deductions & Benefits Elections / Deducciones y Beneficios

I consent to authorized deductions and understand that statutory garnishments, tax levies, and court-ordered deductions will be applied as required by law. Doy mi consentimiento a las deducciones autorizadas y entiendo que las órdenes judiciales se aplicarán según la ley.

Employment History / Historial de Empleo

Education / Educación

Graduation or Completion Date:

References / Referencias

Emergency Contact / Contacto de Emergencia

Legal Disclosures and Certifications / Divulgaciones Legales y Certificaciones

At-Will Employment: I understand that, unless otherwise provided in a separate written agreement signed by an authorized company representative, my employment is at-will and may be terminated by either party at any time, with or without cause. Empleo a voluntad: Entiendo que mi empleo puede terminarse por cualquiera de las partes en cualquier momento, salvo acuerdo escrito en contrario.

Equal Opportunity: The Employer prohibits discrimination and provides equal opportunity for employment, promotion, and compensation without regard to protected characteristics. Igualdad de oportunidades: El empleador prohíbe la discriminación y ofrece igualdad de oportunidades de empleo.

Electronic Pay Statement Consent: By completing this form I consent to receive pay statements and required payroll notices electronically in my chosen language when available. Al completar este formulario doy mi consentimiento para recibir comprobantes de pago electrónicamente en el idioma elegido cuando sea posible.

Verification and Background Checks: I authorize the Employer and its agents to verify the information provided, contact prior employers, and conduct background checks where permitted by law. Autorizo la verificación de la información y verificaciones de antecedentes, según lo permita la ley.

Wage Withholding and Deductions: I acknowledge that the Employer will make required withholdings for taxes, garnishments, and other lawful deductions. Reconozco que el empleador realizará las retenciones y deducciones legales requeridas.

Applicant Certification and Authorization / Certificación y Autorización

I certify under penalty of perjury that the information provided on this form is true, correct, and complete to the best of my knowledge. I authorize the Employer to rely on this information for payroll and tax reporting and to make deductions authorized herein. I understand that submitting false information may subject me to disciplinary action, up to and including termination. Declaro bajo pena de perjurio que la información en este formulario es veraz y completa. Autorizo al empleador a usar esta información para nómina y retenciones fiscales.

Sign Now