New Employee Information

Federal Form W-4
Please complete the Federal Form W-4 by following the steps below:

Step 1: Download a copy of Form W-4.
Step 2: Complete, sign and date the Employee's Withholding Certificate (Page 1). For further assistance with completing Form W-4, please refer to Specific Instructions provided on Page 2. For additional assistance, please refer to the Frequently Asked Questions as published by the IRS.
Step 3: Upload your completed Form W-4 using the secure upload found below under Upload Documents. We will accept a scanned copy or a cell phone photo copy of your completed and signed Form W-4.

Direct Deposit Authorization
• For verification purposes, please be prepared to upload a copy of a voided check (not a deposit slip) for each new account which shows the account number and bank routing number for each financial institution.
• If depositing to a Savings Account, ask your bank for the routing/transit number for your account as the number on the deposit slip may not match your account number.

Do you need to enter partial deposit amounts to multiple bank accounts?*

Yes
No

Effective date*

ACCOUNT #1

Action*

Start
Change
Stop

Type*

Checking
Saving

Deposit*

Full net
Partial net amount
Percent of net

Partial net amount*

Percent of net*

ACCOUNT #1 BANK INFORMATION*

Routing Number	Account Number	Bank Name	City and State

ACCOUNT #2

Action*

Start
Change
Stop

Type*

Checking
Saving

Deposit*

Full net
Partial net amount
Percent of net

Partial net amount*

Percent of net*

ACCOUNT #2 BANK INFORMATION*

Routing Number	Account Number	Bank Name	City and State

ACCOUNT #3

Action

Start
Change
Stop

Type

Checking
Saving

Deposit

Full net
Partial net amount
Percent of net

Partial net amount*

Percent of net*

ACCOUNT #3 BANK INFORMATION

Routing Number	Account Number	Bank Name	City and State

Authorization*

Please scroll to read the entire authorization before checking the box below.

I hereby authorize my employer to initiate credit entries and initiate, if necessary, debit entries and adjustments for any credit entries in error to my account(s) indicated above. The Bank(s) named above have my authorization to credit and/or debit the same such account(s). This authority is to remain in full force and effect until the employer has received written notification from me or its termination in such time and in such a manner as to afford the employer reasonable opportunity to act on it or until my employment is terminated for any reason.

I hereby authorize designated amount(s) to be deposited in the account(s) as stated above.

Date*

Employee signature*

Use your mouse or touch pad to add your signature.

Upload Documents
Please upload your WELS Employee Data Form, Form I-9, bank document(s), your Federal Form W-4 and, if applicable, your State Form W-4.

Upload*

• File extensions allowed: pdf, doc, docx, jpg, xls, xlsx, zip
• Maximum file size allowed: 4MB

Drop files here or

Accepted file types: pdf, doc, docx, jpg, zip, xls, xlsx, Max. file size: 25 MB, Max. files: 3.

Privacy Policy

Data Privacy & Permission*

I AGREE with the terms of the WELS Privacy Policy.

NOTE TO EU CITIZENS, RESIDENTS, TOURISTS, AND OTHER PERSONS TEMPORARILY IN THE EU:

By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy.