Please enable JavaScript in your browser to complete this form.Services Required *PayrollBookkeepingBenefitsTaxesLegal employer name (as registered with the State and IRS) *Physical Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCheck if mailing address is different from your physical addressMailing Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmployer County *Email *EmailConfirm EmailPhone *Appointed payroll contact *FirstLastRequested date of 1st payroll run by Tailored Business *Number of Employees *1 - 51 - 55 - 1010 - 2020 -5050 - 100100 +Pay Frequency *Weekly - $8.50/checkWeekly - $8.50/checkBi-Weekly (every other week) - $12.50/checkSemi-Monthly (15th & 30th) - $12.50/checkMonthly - $15.00/checkPay period runs from *Monday - SundayMonday - SundaySaturday - FridaySunday - SaturdayPay date is *ThursdayThursdayFridayPay period and pay dates are *1st - 15th Paid on 15th (Only available if EES are salaried)1st - 15th Paid on 15th (Only available if EES are salaried)1st - 15th Paid on 30thPay period and pay date *How will employee hours be submitted *EmailEmailSelf-keyed into TB payroll programExcel SpreadsheetCompany-specific time tracking systemOtherPlease specify how employee hours will be submitted *Please specify name of software used for time tracking *Would you like to approve payroll before funds are released *YesYesNoAdditional compensation paid to employees (other than salary & wages) *CommissionsCell phone reimbursementMileageUniformsPer DiemOtherNonePlease specify additional compensation *Do you have a Employer FEIN Number *YesYesNoEmployer FEIN Number (No Dashes) *Do you have a State Unemployement Number *YesYesNoState Unemployment Number (No Dashes) *Primary state where employees work *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDo you have employees working in more than one state *YesYesNoPlease indicate all states where your employees perform work *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingEntity Type *Sole PropSole PropC CorpS CorpLLC (Single Member)LLC (Multimember)PartnershipState of Incorporation *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDate of Incorporation *Owner #1 *FirstLastPercentage of Ownership Selected Value: 0 Do you have more owners to add *YesYesNoOwner #2 *FirstLastPercentage of Ownership Selected Value: 0 Do you have more owners to add *YesYesNoOwner #3 *FirstLastPercentage of Ownership Selected Value: 0 Do you have more owners to addYesYesNoOwner #4 *FirstLastPercentage of Ownership Selected Value: 0 Is your company current with all employment taxes *YesYesNoIndicate periods and agencies you are past due on employment taxes with *Do you have a paid time off policy *YesYesNoDo you have a workers compensation policy *YesYesNoDo you have employee benefits *YesYesNoPlease list any other information you would like Tailored Business to know about your payrollSubmit