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Employee Year-End Verification Checklist

Please confirm your employee information below is accurate by logging into your Employee Self-Service (click here for ESS) or by reviewing your last pay stub. If changes are required, the form should be completed and signed by the employee and submitted to your company's payroll contact. Documents submitted by anyone other than the employer's payroll contact will NOT be processed by Premier Payroll for security reasons. 

Confirm the following are accurate and notify your employer of any changes:

  • Employee Name (spelling of first and last name)

  • Social Security Number (or TIN if applicable)*

  • Street address

  • City, state, and zip code

  • Tax withholding for federal, state, and local taxes:

    • Marital status​

    • Exemptions/additional amounts

  • Banking information for direct deposit

    • Bank name​, routing number, and account number

  • Work or personal email address (for Employee Self-Service, to view W-2 and paystubs)

*SSN or ITIN can be viewed on last year's tax documents if available. Verify with your company's payroll contact directly if needed, as these are masked on paystubs for security purposes.

If changes are required, click here to download the form.

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