W2

CONTRACTOR

NEW HIRE INFORMATION

W2 Contractor Form

Name(Required)
YYYY slash MM slash DD
Address(Required)

WORKSITE/ORDER INFORMATION

Pay Rates/Bill Rates

Supervisor Name(Required)
Background/Drug Screen Ordering Options
Additional charges may apply depending on your county/state of residence
Max. file size: 9 MB.
Submitted By *(Required)
YYYY dash MM dash DD
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