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GET Payroll Deduction Employer Establishment Form

Thank you for your interest in setting up GET Payroll Deduction at your workplace. Complete this form to get started. We will be in contact with you shortly after we receive your completed form.

Name of Employer (Company/Agency/Organization)
Tax ID Number (TIN)
Mailing Address Line 1
Mailing Address Line 2
Mailing Address City
Mailing Address State
Mailing Address Zip
 
Payroll Contact Person
Name:
Title:
Email Address:
Phone Number:
 
Human Resource or Benefits Contact Person
Name:
Title:
Email Address:
Phone Number:
 
Payroll Frequency
1x month:
2x month:
Bi-weekly (26 per year)
Other:
 
Verification Image