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Payroll Request Form
Please complete this form in order for us to understand your needs further and assist you accordingly.
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* Indicates required question
1. Are You a New or Existing Client?
*
I am a new client
I am an existing client
2. Full Name (Include Title)
*
Your answer
3. Phone Number (s)
*
Your answer
4. Email Address
*
Your answer
5. Name of Organization
*
Your answer
6. Nature/ Type of Business
*
Your answer
7. Company Website Address
Your answer
8. Office Location
*
Your answer
9. Business Working Hours
*
Your answer
10. Number of Employees service is required for?
*
1 - 50
51 - 100
101 - 150
151 - 200
Above 200
11. Specific Service Request
*
Payroll only
Statutory payments only
Both
12. Mode of Payment
*
Direct payment from company's account to employee's
Payment from Agency Account to emloyees
13. Mode of Referral
*
Friend/ Colleague
Internet/ Website
Social Media
Other:
14. Any Other Information
Your answer
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