• Client Onboarding Information Request

    Client Onboarding Information Request

  • The following information is required to create a new hire record for your organization. This information is handled with HIPAA Compliance. Please do not print this form and attempt to hand-write the information in. Your signature will be captured electronically at the end of this form and you will receive a confirmation email upon submission. Thank you.

  • Today's Date
     / /
    2 digit month, 2 digit day, 4 digit year

  • CURRENT CLIENT DETAIL

  • NEW HIRE DETAIL

  • Estimated Start Date of Employment with Lightsource Global*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Employee Status*
  • If 'Temporary', please note Employment End Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Do you offer Allowances?*
  • Allowance Information
    Rows
  • Do you offer Bonuses?*
  • Bonus Information
    Rows
  • Do you offer Commission / Incentive compensation?*
  • Commission / Incentive Information
    Rows
  • Will this Employee be eligible for Expense Reimbursements?*
  • Will this Employee be eligible for Paid Time Off (PTO) / Sick / Vacation?*
  • Rows
  • Will this Employee be eligible for Benefits? (Full-time EEs Only)*
  • Full-time Employees are eligible for health benefits in the US and Employers are required to contribute towards their medical premiums. Please list your contribution amount(s) below for each coverage tier. (NOTE: The minimum amount for 2022 is $337 per month and $363 for 2023, there is no maximum.)
    Rows
  • Image field 268
  • Image field 269
  • Will this Employee be eligible for a 401(k) / Retirement / Pension Plan?*

  • Please send your new employee the following link to complete. Please feel free to click on the link to view the simple form your new hire will complete for our employment purposes.

    EMPLOYEE NEW HIRE INFORMATION FORM

    Thank you for choosing Lightsource Global for your EOR needs. We appreciate your partnership.

  • CERTIFICATION & SIGNATURE

    The undersigned attests that the information contained in this document is true and correct to the best of the undersigned’s knowledge. The undersigned understands this document is not a contract for service or employment nor will it bind coverage of any kind. This information is strictly governed by HIPAA compliance rules. In the event that information has been intentionally omitted or misrepresented, the employer of record may deny or limit services. I will notify Lightsource Global of any changes to the information imparted here that occur after signing this form.

  • Should be Empty: