Employee New Start Paperwork

EMPLOYEE NEW START PAPERWORK

Employer Name:    Location/Worksite:

Personal Information

Date of Birth:    Social Security Number (last 4 digits acceptable):

Primary Phone:    Email Address:

Relationship:    Phone:

Position Information

Job Title:    Department:

Reporting Manager:    Work Schedule / Shift:

Start Date:    Employment Status: Full-time Part-time Temporary/Seasonal

Compensation: $    Pay Frequency: Weekly Bi-weekly Monthly

Employment History (Most Recent First)

Job Title:    Start Date:    End Date:

Job Title:    Start Date:    End Date:

Education

Graduation Date:    Major/Field of Study:

Professional References

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Legal Disclosures & Authorizations

At-Will Employment: I acknowledge and understand that, unless set forth in a separate written agreement signed by an authorized representative of the employer, my employment is at-will and may be terminated by me or the employer at any time, with or without cause or prior notice.
I acknowledge and accept the At-Will Employment statement.

Equal Employment Opportunity: The employer is an equal opportunity employer. Employment decisions are made on the basis of qualifications, merit and business needs. The employer prohibits unlawful discrimination and harassment.
I acknowledge receipt of the Equal Employment Opportunity statement.

Authorization to Verify and Background Screening: I authorize the employer and its authorized agents to contact my previous employers, references, educational institutions, and other listed sources to verify information provided. I further authorize the employer to obtain a consumer report, criminal history, motor vehicle record, and other background information as permitted by law. I understand that any adverse information may affect employment eligibility and that I will be notified and given an opportunity to dispute any report in accordance with applicable law.
I authorize verification and background checks as described above.

Criminal Conviction Disclosure: Have you ever been convicted of a felony or misdemeanor which has not been annulled, expunged, or sealed by a court?   Yes No    If yes, provide details:

Direct Deposit & Tax Withholding (Optional)

Direct Deposit Authorization: I authorize the employer to initiate deposits to my account and, if necessary, debit entries to correct errors. This authorization will remain in effect until revoked in writing.
I authorize direct deposit and will provide bank details below.

Routing Number:    Account Number:    Account Type: Checking Savings

Applicant Certification

I certify that all information provided on this form is true, correct, and complete to the best of my knowledge. I understand that false statements, omissions, or misrepresentations may result in disciplinary action up to and including termination of employment. I authorize the release of any information necessary to verify the accuracy of the information provided and to complete required pre-employment checks.

I acknowledge that I have received, read, and understand the employer's policies provided to me and that I agree to comply with those policies as a condition of employment.
I acknowledge receipt of employer policies and handbook (if provided).

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