Trillium Talent Resource Group

EMPLOYEE PAYROLL INFORMATION

Start Date:

Employee #:

FIRST NAME:

LAST NAME:

ADDRESS:
	House #	Street Name	Apartment #

City:

Province:

Postal Code:

HOME #:

CELL #:

EMAIL ADDRESS:

SOCIAL INS. #:

BIRTH DATE:
	Month	Date	Year

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

EMERGENCY CONTACT:

NAME:

TELEPHONE:

BANKING INFO:

BANK INFO ATTACHED

BANK INFO EMAILED

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

OFFICE USE ONLY

Client Placement:

HOURLY RATE:

WSIB RATE:

Light Industrial/Non Clerical
Clerical
Others:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Email Address(To whom the pdf wil be mailed)