New employee information form

Here is a sample new employee information form:

New Employee Information Form

Employee Information:

• Name: _____
• Date of Birth: __
• Social Security Number: __
• Address: __
• City: __
• State: __
• Zip: ___
• Phone Number: __
• Email Address: __

Emergency Contact Information:

• Name: _____
• Relationship: ___
• Phone Number: __
• Email Address: __

Employment Information:

• Job Title: __
• Department: ___
• Supervisor: ___
• Start Date: ___
• Expected End Date: __

Benefits Information:

• Health Insurance: _____
• Dental Insurance: _____
• Vision Insurance: _____
• Life Insurance: __
• Disability Insurance: __
• Retirement Plan: __

Tax Information:

• W-4 Form: ___
• State Tax Withholding: ___
• Local Tax Withholding: ___

Other Information:

• Previous Work Experience: __
• Education: __
• Skills: __
• Special Requests or Accommodations: __

Authorization:

• I hereby authorize [Company Name] to verify the accuracy of the information provided above.
• I understand that providing false information may result in disciplinary action, up to and including termination.

Signature: __ Date: ___

Note: This is a sample form and may need to be modified to comply with your company's specific policies and procedures. It's also a good idea to have a lawyer review the form to ensure it is legally binding.