SOUTHWESTERN PAYROLL SERVICE, INC.
Salesman______Status: New Company /No History/YTDS Company Code______
Legal Name and Contact Information
Legal Name (From IRS)______
DBA (If Any)______
Legal Address______
City______State______Zip Code______-______
Name of Decision Maker______
Proper Title______Ph. #______
Payroll Contact______Title______Ph.#______
Secondary Contact______Title______Ph.#______
Company Fax #______Email ______
Referral Source______Nature of Business ______
Client CPA? Y / N CPA Name______
CPA Address______City______State_____ Zip Code______-_____
CPA Phone______CPA Fax______
Tax Information
Tax Service: Full / None Tax Processing to Start: Year ______Quarter ______
Any Tax Exempts: Yes / No (If yes, fill out the appropriate Part of page 9.)
FED ID#______FED Tax Dep Freq: S / M Rec’d Proof
PRIMARY ST_____ ID#______ST Dep Freq_____ Filing Freq Rec’d Proof
PRIMARY SUI ID#______Rate______Rate Confirmation Rec’d Proof
Addt’l States? Y / N (If yes, fill out the appropriate part of Page 9.)
Are we paying taxes for our new client as part of the history pick up? Yes / No
(If yes, fill out the appropriate Part of page 9.)
Pay Frequency & Calendar Information
Pay Frequency: W / B / S / M Other______
1st Ck Date______Period Beg.______Period End______Process Date______
2nd Ck Date______Period Beg.______Period End______Process Date______
If check date falls on Saturday – Move to:Previous Business Day/ Next Business Day
If check date falls on Sunday – Move to:Previous Business Day/ Next Business Day
If check date falls on a Holiday – Move to:Previous Business Day/ Next Business Day
(W or B) Ck Day ______Period Beg Day______Period End Day______Process Day______
Billing Information
Billing Name______Attn______
Address______City______State______Zip Code______-______
Terms:ACH Transfer /Due Upon Receipt/ITEX
Delivery Information
Delivery Method: SPSICourier Mail Client Courier Pickup FedEx UPS Lonestar DHL
Client Acct#______Delivery Day Next M T W Th F Deliver Before____:____
Delivery Name______Attn______
Address______
City______State______Zip Code______-______
Special Delivery Notes or Hours ______
______
Client Services
ServicesBilled?Disc Delivery ChargesBilling Amt
Tax Processing Y / NY / N______Courier______
New Hire ReportingY / NY / N______FEDEX______
*Direct DepositY / NY / N______Lonestar______
*Check SigningY / NY / N______First Class Mail ______
Check EnvelopingY / NY / N______Priority Mail ______
BundleY / NY / N______Paperless
Direct CheckY / NY / N______
*Agency ChecksY / NY / N______Packout Notes
*General LedgerY / NY / N______
*Benefit AccrualY / NY / N______
*401K ReportingY / NY / N______
*401K Export Y / NY / N______
EE Self-ServiceY / NY / N______
Paperless PayrollY / NY / N______
*Workers CompY / NY / N______
Gallagher ClientY / N Billing Table ______
Time & AttendanceY / N______Wire Transfer: Yes No
Garn ServiceY / N______
HRAnswer LinkY / N______Payroll Specialist: ______
HR On-DemandY / N______
Applicant TrackingY / N_____Input Type: Fax-In / Payentry.com
(* Indicates addt’l info is needed to setup)
Additional Reports E-mail / Call-In / PC Input / Auto
Name______Freq______Sort By______(Freq – Every PR; 1st PR of mo; last PR of mo; last PR of Qtr)Name______Freq______Sort By______(Sort By – Dept ID; Dept Name; EE ID; Name)
Earnings
Code Desc Taxability Type Rate Reduce Match Agency
(FITW, FUTA, MED, MED-R, SITW, SUI, SS, SS-R) Autopay Ded
1-Reg_Regular_ Y / Y / Y / Y / Y / Y / Y / Y_ _Reg_ 1.0_Y / N ______
1-Sal_ Salary_ Y / Y / Y / Y / Y / Y / Y / Y_ _Reg_ ____Y / N ______
2-OT Overtime Y / Y / Y / Y / Y / Y / Y / Y_ _OT_ _1.5_Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
______Y / N ______
Special Instructions: ______
______
______
______
______
______
______
______
______
______
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
Earning Types:
3PSP-LT = Third Party Sick Pay - Long Term
3rd Pty Sick = Third Party Sick Pay – Taxable
Banquet Tips = Banquet Tips
Cash Tips = Cash Tips
Charged Tips =Charged Tips
GTL =Group Term Life Insurance
Memo 3PSP-NT = Third Party Sick Pay – Nontaxable
Memo Hours = Memo – Hours Only – amount forced zero
Memo Pr Wages =Prior Employer Wages
Memo =Memo – Does not add to gross
MemoERMatch = 401(k) Employer Match Memo Code
MemoGrsRecpt = Gross Receipts (use for tip allocation)
MemoTipAlloc = Tip Allocation Amount
MemoWC = Special Workers Comp Memo Code
OT = Overtime Pay
OT-Weighted =Weighted Average Overtime
Reg = Regular Pay
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
Deductions
Partial
Code Desc PT/AT Drop Chk Stub
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
______Y / N Y / N
Special Instructions: ______
______
______
______
______
______
______
______
______
______
______
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
Deduction Types:
125 = 125
129 = 129
401k Loan =401k Loan
401k Over =401k Over
401k =401k
403b = 403b
408k = 408k
457b = 457b
501c = 501c
Add = Add
IRS Levy = IRS Levy
KJDAC=KJDAC
KJDAS=KJDAS
Levy = Levy
Memo = Memo
Roth 401k=Roth 401k
Simple 401k=Simple 401k
Simple = Simple IRA
State Levy = State Levy
WA L+I = WA L+I
WC = WC
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
N/A Input Worksheet Column Headings
#1______#2______#3______#4______#5______#6______#7______#8______#9______
Department Structure
(If none default to Staff)
# of Levels______(up to 5)
CC1______
CC2______
CC3______
CC4______
CC5______
Level / Code / NameN/A Workers Compensation Information
State / Code / Description / Rate / Exp. Mod.Employee Information
Approx. No. of Employees______Employee Number: Use Theirs / Start W/#______
W-4’s Collected W-4 Info From Other Source W-4’s Checked for Additional Information
Any 1099 EE’s? Y / NDo all EE’s work in one state? Y / N
Direct Deposit? Y / N
Additional Notes: ______
______
______
N/A 401k Info
Provider?______
Contract #’s ______
Contact Info: ______
Is there a 3rd Party Administrator handling day to day activities? If so, who?
______
Are you Roth eligible? Yes No
How are contributions made? (ACH, check, upload, etc) ______
How do you define total compensation vs. plan compensation? ______
______
Are there 401k loans? Yes No
______
______
______
______
______
401K Match Calculation Info:
ER Matches ______% of EE’s Contributions on the first ______% of Earnings
ER Matches ______% of EE’s Contributions on the next ______% of Earnings
Additional Comments:______
______
______
______
N/A Agency Checks
CODE______Payee______
Address______City______State______Zip Code______-______
Freq______3rd Pty Acct______3rd Pty ABA______
Notes______
CODE______Payee______
Address______City______State______Zip Code______-______
Freq______3rd Pty Acct______3rd Pty ABA______
Notes______
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
Frequencies:
A1 = 1st Check Date of the Year
AL = Last Check Date of the Year
B = Biweekly
DC = Discontinued
M = Monthly
M1 = 1st Check Date of the Month
ML = Last Check Date of the Month
O = Once
Q = Quarterly
Q1 = 1st Check Date of the Quarter
QL = Last Check Date of the Quarter
S = Semi Monthly
W = Weekly
W_1-4 = Weeks 1 – 4
W1 = 1st Week
W2 = 2nd Week
W2Billing = W-2 Billing
W3 = 3rd Week
W4 = 4th Week
W5 = 5th Week
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13
Bank Account
Voided Check Rec’d Next Check #______Days to Void: 30 / 60 / 90 / NA
Signature on Ck: Y / N # of Sig Lines: 1 / 2 Logo on Ck: Y / N Logo Rec’d
Company Name on Check______
Address 1______
Address 2______
City______State______Zip Code______-______
Sort Order: Dept ID / Dept Name / EE ID / Last Name / Other______
Funds For: PayCks / DirChk / DirDep / 3rdPtyCks / Taxes / Billing
ATTACH VOIDED CHECK HERE
Will direct deposit be over $50,000? Yes No In the future? Yes No
N/A Wire Information
Draw Down Yes No Becky notified Yes NoClient Initiated Yes No Documents completed Yes No
N/A PTO Accrual Info
Do you have a written policy?
Is this frequency (SM,M) based or hours based?
If hours, what earnings are to count towards the accrual?
What types of accruals do you have? (VAC, PTO, etc.)
What are the tiers for the accruals? (ex: 0-1 years = 40 hours, 1-3 years = 80 hours, etc.)
Are there balances that need to be carried over?
Do you carry over current balances at the end of the year, or start from zero?
Do you have anniversary date accruals? If so does the accrual rate change on the actual anniversary day, or at the start of the anniversary year?
Do you want the hours displayed on the check stubs, can be displayed as hour, amounts or both?
N/A Additional States
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
State______ID#______Rec’d Proof
St. Dep. Freq.______Filing Freq. ______
SUI ID# ______Rate ______Rate Confirmation ______Rec’d Proof
Login Credentials for State Tax Websites: ______
______
______
______
______
______
N/A Exemption Details
Taxes client is exempt from paying: FUTA / SUTA
Basis for exemption: ______
______
______
N/A History Pickup Details
History pickup by Quarter:
1st QTR______3rd QTR______
2nd QTR ______4th QTR ______
History pickup by Pay Period:
1st Month: ______
2nd Month: ______
3rd Month: ______
Other history pickup details: ______
______
______
______
______
N/A Taxes to be Paid as Part of History Pickup
What taxes are we paying and when are they to be paid as part of the history pickup?
FUTA / SUI / SITW / FITW
Due Date:____
(If ANY taxes are being paid as part of the history pickup, fill out Pages 10 AND 11. Make sure client receives fax of
Page 11 before initiating any ACH transfers.)
NEW CLIENT HISTORY PICKUP
ACH INFORMATION
Amount ______
Client No.: Client:
Banking activities to be performed:
Transfer from (CCD27): CLIENT______Account #
Transfer to (CCD22): Cash – M3 Tax Account # 361372_____
GENERAL LEDGER INFORMATION
Escrow G/L entry to be made because of banking activityperformed above (ACH transfer):
Transfer Date
YearQtrAmount
Cash - M3 Tax $ DR
941 $ CR
940 $ CR
SITW $ CR
SUI $ CR
Please attach the ACH transaction report from M3.
SOUTHWESTERN PAYROLL SERVICE, INC.
11008 E. 51st, Tulsa, OK74145 (918) 587-3321 FAX (918) 587-0001
MEMORANDUM
TO:______
______
Phone No.______
Fax No. ______
FROM:Ray Fowler
Southwestern Payroll Service, Inc.
DATE:______
SUBJECT:ACH Debit Entry
During the process of picking up your payroll history, it was determined that payroll taxes were unpaid and need to be paid. You have requested that Southwestern Payroll Service, Inc. file and pay various payroll taxes associated with this payroll history.
In order to file and pay these payroll taxes we must initiate an ACH debit on your account for the following:
Federal 941 Taxes
Date: ______
Federal Unemployment Taxes
Date: ______
OklahomaState Withholding Taxes
Date: ______
Oklahoma Unemployment Taxes
Date: ______
Total ______
The effective date of this ACH debit entry will be ______.
If you have any questions please call me at 388-3310.
C:\Documents and Settings\mwarren\Local Settings\Temporary Internet Files\OLK13\M3_New_Client_Setup_Form III.doc Page 1 of 13