Alterity New Hire

Contact Information
Name*
First Middle Initial Last
Nickname
What name would you prefer for clients, colleagues and your email address?
(e.g., Ally for Alexandra, Zach for Zachary)
Other Names
e.g., maiden name
Mobile Number*
Email*
Address*
Street Address Address Line 2 City State ZIP Code

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Employment Eligibility
Alterity is required to obtain a completed Form I-9 for every new employee. Federal and state laws require employers to report new hires. Refer to the Employment Eligibility Verification Employee Information Sheet for more information.
Date of Birth*
Date Format: MM slash DD slash YYYY
Citizenship Status*
Alien Registration or USCIS Number*
Number Type*
Is the above number an Alien Registration Number or a USCIS Number?
Social Security Number*
Document(s) for Form I-9*
What form(s) of identification can you bring with you, on or before your first day of work?
US Passport - Number*
US Passport - Expiration Date*
Date Format: MM slash DD slash YYYY
Drivers License - Number*
Drivers License - State*
Drivers License - Expiration*
Date Format: MM slash DD slash YYYY
Document(s) for Identification*
Please provide us with the Document Title, Issuing Authority, Document Number and Expiration Date (if any) for the document(s) that you will be providing for Employment Eligibility Verification.

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Payroll Info and Taxes
Alterity will provide you with IRS Form W-4 (pdf) to sign on your first day of employment. The following information will help us to begin working on your payroll.
Marital Status*
*Head of household only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.
Bank Name*
Bank Routing Number*
Bank Account Number*
Bank Account Type*
Second Bank Account*
Would you like to split your pay between two bank accounts?
Second Bank Name
Second Bank Routing Number
Second Bank Account Number
Second Bank Account Type
Second Bank Split
How would you like to split your pay into the two accounts? For example, "First $500 to Primary, Balance to Second"

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Equal Employment Opportunity
Alterity does not discriminate based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability and genetic information (including family medical history). We provide equal pay for equal work.

As a small business employer, Alterity is not required to report data about the ethnicity, race and gender of our workforce to the government. However, the following information is requested to better understand our progress in diversity. In the future, we may be required to report this information.

Self-reporting
Gender
Race / Ethnicity
US Veteran
Military Status
Disabled
Description of Disability

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Contact Information