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APPLICATION
Name of your Representative
Company Name
EIN Number
Legal Name
# of Locations
Legal Address
Contact
Phone Number
Email
Owner
% of Ownership
On Payroll?
Owner
% of Ownership
% of Ownership
On Payroll?
Owner
On Payroll?
Business Type
NP
Sole Proprietorship
S Corp / C Corp
LLC
Current # of Full Time Employees on Payroll
Current # of Part Time Emplyess on Payroll
Payroll Processing Company
Payroll Frequency
Phone Number
Email
Completed by:
Title
Date
Best Time for Zoom Call
Monday
Tuesday
Wednesday
Thursday
Friday
AM or PM?
AM
PM
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