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Employee Signup

1. Personal

a. First Name b. Middle Name c. Last Name d. Date of Birth e. Address f. City g. State h. Zip i. Phone number j. Email Address k. SSN

2. Banking

a. Bank Account # b. Routing #

It is mandatory for ALL employees to choose DIRECT DEPOSIT. Exceptions may apply.

Direct Deposit Check

3. W-4 Prior to 2019

a. Relationship Status

Single or Married filing separately

Married filing jointly or Qualifying widow(er)

Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

b. Claim Dependents

Enter '0' if none.

4. W-4 2021

a. Relationship Status Single or Married filing separately

Married filing jointly or Qualifying widow(er)

Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

b. Claim Dependents

(Multiply the number of qualifying children under age 18 by $3,000.

Multiply the number of other dependents by $500.)

Add the amounts above and enter the total here:

Enter '0' if none

5. Michigan W-4

a. Driver's License Number b. Are you a new employee? Yes.

Enter date of hire:

No.

c. Enter the number of personal and dependent exemptions

6. Agreement

By checking this box you are hereby agreeing that all this information is valid and yours. I Agree.