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Authorization Form
Payment Method Change Form
Submit Payroll
Pay-As-You-Go
Services & Solutions
For Business Owners / Policyholders
For Insurance Carriers
For Payroll Providers
For Insurance Agents/Brokers
Audit Review
About
Contact
Authorization Form
Payment Method Change Form
Submit Payroll
Payroll submission form
INSTRUCTIONS
Submit your payroll files using the form below.
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Company Name*
*
Email*
*
Check Date*
*
Comments
Important:
If the pay date and pay periods aren't specified within the report, please include them. Failure to meet these requirements could lead to delays in processing.
File Upload*
*
Click or drag a file to this area to upload.
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