New Hire Intake Form

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Worker Classification

Select before proceeding — determines required fields

Worker Type *

👤 W-2 Employee Full-time / part-time staff on payroll

🤝 1099 Contractor Independent contractor / project-based

📋

Personal Information

Legal name and contact details

First Name *

M.I.

Last Name *

Personal Email *

Phone *

Street Address

City

State

ZIP Code

🏢

Role & Assignment

Position details and company assignment

Job Title / Role *

Department *

Start Date *

Supervisor / Hiring Manager

Employee # (Assigned by HR)

PCG-

Company Email to Issue

💼

W-2 Employee — Payroll & Tax

Federal and California withholding setup

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SSN Security Notice Do NOT enter Social Security Numbers digitally. Collect SSN on paper I-9 and W-4 forms only. Store originals in the locked HR file.

W-4 Filing Status

Additional Federal Withholding ($)

Pay Rate *

Pay Frequency

Set Up Direct Deposit? Toggle ON to enter banking information

NO

⚠ All direct deposit fields are required when direct deposit is enabled.

Bank Name *

Routing # *

Account # (last 4) *

Account Type *

Emergency Contact

Contact Name

Contact Phone

🤝

1099 Contractor — Tax & Payment

W-9 info and payment setup

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TIN / SSN / EIN Security Notice Do NOT enter Tax ID Numbers digitally. Collect TIN on paper W-9 only. Verify AB5 classification before submitting this form. When in doubt — consult a CA employment attorney.

Business / Entity Name (if different)

Entity Type

Contract Rate

Payment Method

W-9 Submitted?

AB5 Classification Verified?

📝

Additional Notes

Special arrangements, equipment, access needs

Notes

Submitted By (HR Rep)

Submission Date

New Hire Recorded

📋 Record Summary

📊 Copy Row → Paste into Employee Database

✅ Next Steps