* Indicates Required FieldName*Email Address*Phone Number*Number of EmployeesFrequency of PayrollWeeklyBi-WeeklyMonthlySemi-MonthlyAnnuallyWeekly-SeasonalNumber of States InvolvedLocal Taxes (Local & City)Would you like direct deposit or checks?Direct DepositCheckAre we to file your taxes electronically?YesNoMethod of delivery? (courier, UPS, email - for direct deposit)CourierUPSEmailOtherWill you require 401k reporting?YesNoDo you require a certified payroll?YesNoCurrent provider’s chargesOther Comments: