AllStaff Payroll Services

Employee Application

Instructions for Filling Out an Online Application

Carefully complete each form and press submit. Make sure that all the information you are providing is accurate. If you do not wish to complete all forms at once, you may return later and proceed where you left off. Try to complete all forms in order they appear. The forms you are asked to complete will establish your record with us and become a part of your personnel file.

Employee Online Application Information

The company which has offered your employment has contracted with All Staff Payroll, Inc. to provide Human Resource services and share some of your new employers responsibilities. Therefore, you are being requested to complete the attached forms since All Staff Payroll, Inc. will also become your employer. Although All Staff Payroll, Inc. will be responsible for some things such as payroll, and workers’ compensation claims, your company will maintain control over the work activities at your worksite.

ALLSTAFF PAYROLL, INC. maintains all required personnel records for your employer. Please complete all forms included in this packet in order to establish your personnel file with us. Once your employment officially begins, it is important to notify ALLSTAFF PAYROLL, INC. immediately to disclose any changes in your personnel information, such as address changes, W-4 changes, depository account changes, etc.

All forms are critical to the accuracy of your payroll records. ALLSTAFF PAYROLL, INC. requires that you respond carefully and completely. We appreciate your full cooperation.

You will need to fill out the following forms in the upcoming steps:

  • Employee Information Form
  • Form W-4 (2017)
  • Employee Insurance Benefits
  • Safety Policy
  • Employee Direct Deposit Authorization Form

If you have any questions regarding this material, please speak with the ALLSTAFF PAYROLL, INC. Human Resource representative. Should you have any questions at a later time, please feel free to call the ALLSTAFF PAYROLL, INC. office at (850) 434-6708.

If you move or change your address, it is your responsibility to notify ALLSTAFF PAYROLL, INC. of an address change prior to W-2s going to print, as the address cannot be changed during or after printing. ALLSTAFF PAYROLL, INC. and your employer are not responsible if you do not receive your W-2 due to an incorrect address on file.

Remember to notify ALLSTAFF PAYROLL, INC. of all changes to your personnel information!

Employee Information Form

AllStaff Payroll, Inc. is an equal opportunity employer. No person is unlawfully excluded from consideration for employment because of age, race, color, religious creed, national origin, ancestry, gender, genetic information, veteran status, marital status or physical challenges.

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(Proof required)

(Other than a minor traffic violation)

(Conviction of a crime is not an automatic bar from employment)

I certify that all the facts and information listed on this form are true and complete. I understand that any false, incomplete or misleading information given by me on this form, regardless of when it is discovered, is sufficient cause for rejection of my application or termination of my employment. I hereby authorize ALLSTAFF PAYROLL, INC. to investigate all statements contained on this form, to interview references and previous employers listed on this form. I authorize all references to give ALLSTAFF PAYROLL, INC. all information and opinions concerning my previous employment and me. I release all such parties from any liability, which may arise from furnishing such information to ALLSTAFF PAYROLL, INC. including, but not limited to, any liability for defamation or invasion of privacy. If I am employed by ALLSTAFF PAYROLL, INC., I understand and agree that I will be assigned to a jobsite employer contracting with ALLSTAFF PAYROLL, INC., and that I will be required to comply with the policies set forth by ALLSTAFF PAYROLL, INC. and regulations of the jobsite employer. In the event of conflict between the policies of ALLSTAFF PAYROLL, INC. and the jobsite employer, ALLSTAFF PAYROLL, INC. policy shall prevail. I understand that if I am hired, I will not be considered to be working for ALLSTAFF PAYROLL, INC. until I have satisfied all post-offer medical inquiries and examinations. I also understand that I will be required to serve a (90) day probationary period, and that I may be discharged at the end or anytime, regardless of successful completion of my probationary period at the option of ALLSTAFF PAYROLL, INC. No one other than the President of ALLSTAFF PAYROLL, INC. has the authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the forgoing. I acknowledge and agree that if I am subjected to any type of discrimination and/or harassment, or have any other employment related disputes or claims; I will contact the ALLSTAFF PAYROLL, INC. President or Human Resources representative immediately.

By clicking in the box marked “I agree”  at the bottom of this page, you consent to the following:

  • The use of electronic communications, electronic records, and electronic signatures rather than paper documents for the forms provided on this website.
  • You acknowledge your understanding that your electronic signature is legally binding, just as if you had signed a paper document. Your consent to use electronic signatures and documents applies to all activities and requests on this website.

Form W-4

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.

Please download and fill out the following form. After you have filled it out, save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Once completed, continue to the next form.

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Right-click to download this form to your computer.

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Choose the file on your hard drive.

File name:

File size:

All Forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

Alabama Employee’s Withholding Exemption Certificate

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Press submit.

image

Right-click to download this form to your computer.

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File name:

File size:

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

By clicking “Submit”, you certify under penalty of perjury that you are entitled to the number of withholding allowances or the exemption from withholding status claimed on this form. Also, you authorize your employer to deduct per pay period the additional amount listed above.

Georgia Employee’s WIthholding Allowance Certificate

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Press submit.

image

Right-click to download this form to your computer.

image

File name:

File size:

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

By clicking “Submit” you certify under penalty of perjury that you are entitled to the number of withholding allowances or the exemption from withholding status claimed on this form. Also, you authorize your employer to deduct per pay period the additional amount listed above.

Louisiana Employee’s Withholding Exemption Certificate

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Press submit.

image

Right-click to download this form to your computer.

image

File name:

File size:

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

By clicking “Submit”, you certify under penalty of perjury that you are entitled to the number of withholding allowances or the exemption from withholding status claimed on this form. Also, you authorize your employer to deduct per pay period the additional amount listed above.

Mississippi Employee’s Withholding Exemption Certificate

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Press submit.

image

Right-click to download this form to your computer.

image

File name:

File size:

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

By clicking “Submit” you certify under penalty of perjury that you are entitled to the number of withholding allowances or the exemption from withholding status claimed on this form. Also, you authorize your employer to deduct per pay period the additional amount listed above.

Wisconsin Employee’s Withholding Agreement

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Press submit.

image Right-click to download this form to your computer.

image

File name:

File size:

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

By clicking “Submit”, you certify under penalty of perjury that you are entitled to the number of withholding allowances or the exemption from withholding status claimed on this form. Also, you authorize your employer to deduct per pay period the additional amount listed above.

Form I-9

Please download and fill out the following form. After you have filled it out save and upload it.

  1. Download the form using the link below.
  2. Download and install Adobe Acrobat Reader.
  3. Carefully fill out the form and save it.
  4. Upload completed form using Browse button.
  5. Once completed, continue to the next form.

image

Right-click to download this form to your computer.

image

File name:

File size:

All Forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

Work Opportunity Tax Credit Program

Allstaff is participating in the Work Opportunity Tax credit program. We are requesting some information from you to help Allstaff properly complete the analysis. Federal law requires the survey to be completed on or before the hiring decision date. All information you provide will be solely used for purposes of the tax credit and will not affect your job, wages, or taxes in any way. This program is voluntary, but we appreciate your willingness to complete the following survey.

To fill out this survey, please click here.

Employee Insurance Benefits

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Safety Policy

ALLSTAFF PAYROLL, INC. and your employer are committed to safety and have taken steps to prevent workplace injuries. However, the responsibility for safety is shared by everyone. All employees at every level are accountable for complying with safety policies and are responsible for everyone’s safety, including their own. Job safety is often as simple as applying common sense to a situation. Use good common sense and stay alert on the job at all times.

  1. Follow all written and spoken safety rules.
  2. No alcohol or drugs will be used on the job at any time.
  3. Report any hazardous working condition(s) to your supervisor immediately, regardless of whether or not the hazard directly affects you.
  4. If at any time you are not sure of how to perform the job you have been instructed to carry out, STOP AND CHECK WITH YOUR SUPERVISOR.
  5. Do NOT remove or bypass any safety guards, latches, etc. on any machinery at any time.
  6. Do NOT start or operate any equipment without the proper authority and safety instruction. Never operate a piece of equipment when guards or other safety devices are not in place.
  7. Do NOT attempt to repair faulty/malfunctioning equipment. Report the condition to your supervisor immediately.
  8. Any employee who is furnished safety equipment will be required to use such equipment while doing the work for which the equipment was furnished.
  9. Ask your supervisor if additional equipment or instructions are needed to work safely.
  10. Practice good housekeeping at all times. (e.g. clean tools, dry floors, neat work areas, properly arranged materials, etc.)
  11. Do NOT lift loads over 50 lbs. without assistance. Lift with your legs, not your back. If a load is too heavy or awkward for you, ask for assistance.
  12. Do NOT operate any company vehicle without wearing a seatbelt. IT IS THE LAW!
  13. Electrical tool snad cords must have an operational third wire positive ground. Do NOT use these items if this grounding is not present. Double insulated tools must be marked.
  14. Do NOT use flammable liquids, toxic materials, chemicals or acids unless authorized and properly trained.
  15. Do NOT smoke in areas which are not specifically designated as such.
  16. If when reporting for work you feel ill or are emotionally upset due to personal problems, discuss them with your foreman/supervisor before starting work.
  17. Employees under the influence of drugs or alcohol on-the-job will be subject to immediate discharge. Employees taking prescribed medications should advise the supervisor prior to the start of the shift.
  1. All injuries, no matter how slight, must be reported to your supervisor immediately.
  2. Drug tests will be administered at the time of treatment for all accidents.
  3. Obtain authorization from your supervisor for all non-emergency treatments for any accidents.
  4. Submitting false or fraudulent information when reporting injury is a third degree felony and will be cause for dismissal and denial of medical wage loss benefits.

I have read these rules (or I have had them read to me), and understand them and will obey them for my own benefit.

Where injury is caused by the willful refusal of the employee to use safety equipment or obey safety rules, the compensation benefits can be reduced by 25% (Florida Statute 44.09.(4)).

By clicking in the box marked “I agree”  at the bottom of this page, you consent to the following:

  • The use of electronic communications, electronic records, and electronic signatures rather than paper documents for the forms provided on this website.
  • You acknowledge your understanding that your electronic signature is legally binding, just as if you had signed a paper document. Your consent to use electronic signatures and documents applies to all activities and requests on this website.

Employee Direct Deposit Authorization Form

Please attach a voided check to verify routing and account numbers

Incorrect account info will cause your deposit to be rejected and pay will be delayed.

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I (we) hereby authorize ALLSTAFF PAYROLL, INC. to initiate credit entries and, if necessary, debit entries to adjust for credit entries made in error to my (our) checking and/or savings account indicated above. I (we) authorize the financial institution named above to credit and/or debit as requested by ALLSTAFF PAYROLL, INC. If I become subject to any attachment, garnishment, or levy; I understand my participation in direct deposit may be terminated, and I would receive a physical check for my pay. In the event of an employee termination, the final pay may be a physical check.

In order to cancel  or make changes to your direct deposit, written notice MUST immediately be provided to ALLSTAFF PAYROLL, INC. Please include your name, Social Security number and signature with the request.

ALLSTAFF PAYROLL, INC. will set your direct deposits to arrive in your account on your check date. ALLSTAFF PAYROLL, INC. assumes no responsibility for the date and time in which your banking institution credits funds to your account. ALLSTAFF PAYROLL, INC. reserves the right to override this authorization in accordance with your work site agreement.

By clicking in the box marked “I agree”  at the bottom of this page, you consent to the following:

  • The use of electronic communications, electronic records, and electronic signatures rather than paper documents for the forms provided on this website.
  • You acknowledge your understanding that your electronic signature is legally binding, just as if you had signed a paper document. Your consent to use electronic signatures and documents applies to all activities and requests on this website.

Employment Entrance Medical Questionnaire

Please answer the following questions; explain all “Yes” answers:

By clicking “Submit”, I authorize any physician, surgeon or other medical or professional person, dentist, hospital, rehabilitation, nurse, or medical personnel, or employer to release any and all medical information in its possession about me to the company, or its legal representative in the event of an on-the-job injury. Medical information means all information in the possession of or derived from providers of health care regarding the medical history, mental or physical condition or treatment of me. I agree that a photocopy of this authorization shall be as valid as the original. I agree that this authorization shall be valid as long as I am employed by All Staff Payroll, Inc.

All forms are served across a protected, 128-bit SSL connection that encrypts the data before it is sent to our servers.

Form Verification

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organization to provide relevant information and opinions that may be useful in making employment decisions. I release such persons and organization from any legal liability in making such statements.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment screen as a condition of employment if required.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE. I UNDERSTAND THAT THE FIRST 3 MONTHS OF ACTIVE SERVICE WILL BE PROBATIONARY DURING WHICH TIME MY EMPLOYMENT MAY BE TERMINATED WITHOUT NOTICE OF TERMINATION OF EMPLOYMENT OR PAY IN LIEU THEREOF.

I am the submitter of this employment paperwork , I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete and made in good faith.

Please type your First and Last Name

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