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Our Story
Call Us: (802) 864-5155
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New Hire
New Hire
Name
*
First
Last
Home Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone
Email
Gender
*
SSN
*
Date of Birth
*
Date Format: MM slash DD slash YYYY
Actual Start Date
Date Format: MM slash DD slash YYYY
Rate of Pay
*
Direct Deposit
*
Yes
No
W4 Filing Status
*
Single
Married
Married, but withhold at higher Single rate
W4 Deductions Claimed
*
Work Status
*
Part Time
Full Time
Is This Employee a Rehire?
*
Yes
No
This employee is being hired to work
*
Less than 18 hours/week
18 to 29 hours/week
30 to 34 hours/week
35 or more hours/week
Employment Location
*
B1 - 328 North Ave, Burlington
B2 - 103 Shelburne Road, Burlington
B35 - 793 Shelburne Road, South Burlington
B4 - 219 Main Street, Burlington
B5 - 1118 Williston Road, South Burlington
B6 - 315 Shelburne Road, Burlington
B8 - 1800 Williston Road, South Burlington
B9 - 801 Williston Road, South Burlington
BE1 - 15 South Main Street, Barre
BE2 - 169 Washington Street, Barre
BE4 - 475 North Main Street, Barre
BRN - 1 Grove Street, Brandon
BRS - 3 West Street, Bristol
BTH - 137 Main Street, Bethel
C1 - 156 Roosevelt Highway, Colchester
C2 - 3570 Roosevelt Highway, Colchester
DB - 3923 US RT 5, Derby
EB - 127 Main Street, Enosburg
ES1 - 56 Pearl Street, Essex Junction
ES2 - 25 Jericho Road, Essex
FL - 51 Lake Morey Road, Fairlee
LB - 114 Hanover Street, Lebanon
MB - 25 Court Street, Middlebury
MLT - 370 Route 7, Milton
M1 - 5 Memorial Drive, Montpelier
M3 - 108 State Street, Montpelier
NF - 73 North Main Street, Northfield
PF - 3705 US RT 7, Pittsford
RD - 16 North Main Street, Randolph
STJ - 490 Railroad Street, St Johnsbury
SW1 - 188 First Street, Swanton
SW2 - 2 Canada Street, Swanton
VG - 65 Main Street, Vergennes
WF - 5127 Main Street, Waitsfield
WB1 - 1 North Main Street, Waterbury
WB2 - 713 Waterbury Stowe Road, Waterbury
WN1 - 155 Main Street, Winooski
WN2 - 280 East Allen Street, Winooski
