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PAYROLL

Out Of State Hire Preliminary Questionnaire

Name of Hire:
Job Title:
Phone:
Email:
Address:
City, State Zip:
Anticipated Date of Hire:
Estimated Salary:
Resident State:
Work State:
Brief description of work to be performed:

IMPORTANT: The majority of states impose a state income tax. Employees working in these states may also be subject to additional taxes such as city, county, school district, disability, and unemployment withholding taxes. Employers are also subject to payroll tax expenses such as unemployment, disability, and head count taxes. States vary in their requirements to register to do business in their state. Additional information may be needed to complete the state business registration. Please list the name of the FAU contact person who can be reached for additional information.

FAU Department Contact Person

Name:

Phone:

Email:

Submit completed questionnaire to:
Rosa Naujoks
Controller’s Office/Payroll
Email: rnaujoks@fau.edu
Fax: 561-297-1062

Created November 2010
send any comments to Krisa Kolbe

Florida Atlantic University

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