About Our Employer of Record Company | Signature Back Office Solutions

New Client

Company Form

New Client Company Form

Recruiting Firm(Required)

Client Legal Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment Terms(Required)

A/P Name(Required)

First Last

A/P Phone Number(Required)

A/P Email Address(Required)

Purchase Order Number (if applicable)

Business Description(Required)

W.C. Class Code

State Work Performed(Required)

Start Date(Required)

Number of Placements(Required)

Length of Assignments(Required)

Pay Rate(Required)

Bill Rate(Required)

Position Description(Required)

Include an attachment

Max. file size: 9 MB.

Submitted By *(Required)

First Last

Email(Required)

Submitted Date(Required)

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