Employee Information Sheet Employee Name: Address: Phone Number: Email Address: Date of Birth: Social Security #: Marital Status: (Single/Married/Married but withhold at a Single rate) Total Federal Allowances: (Line #5 on a W-4, ex. number of dependants) Additional Federal Withholdings (if any): (Line #6 on a W-4, ex. $25.00) Rate of Pay: $ per hour - OR - $ annually Date of Hire: Additional Deductions (401k, dental, etc. this is optional): Please fill out for Direct Deposit Payroll. Please also fax your voided check to 713-490-3214 or email to info@jubileemga.com Bank Name: Bank Account Number: Bank Routing Number: Entire Amount to be deposited in this account? If not, Amount to be deposited here: Checking AccountSavings Account Bank Name: Bank Account Number: Bank Routing Number: Amount to be deposited here: Checking AccountSavings Account