Mobile New Hire – Horizons Portal

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State W4 Forms
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New Hire Information
i9 Forms

For Mobile Users

Step 1 of 7

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Personal Information

Please enter your personal information and hit next
Name*
First Middle Last
Other Last Names used (if any)
Address*
Street Address Address Line 2 City State ZIP Code

Date of Birth*
Social Security Number*
Email
Phone*
Drivers License Number or ID Number*
ID / Drivers License State*
State

Education
High School Graduate*
Highest level achieved*
Name of School*
Years Attended From-To
School Located
City State / Province / Region Country
College Graduate
Name of College
Years Attended From-To
College Located
City State / Province / Region Country

Payroll Information
Payroll Address (if different from above)
Street Address Address Line 2 City State ZIP Code
Direct Deposit Information
If you do not have a bank account you can skip this
Account Type
Bank Routing Number
Bank Account Number
Notifications
- Send voucher by email
- Send notifications by SMS (Text Message)

Federal Withholding
Filing Status*
- Multiple Jobs or Spouse Works
Number of qualifying children under age 17
Multiply the number of qualifying children under age 17 by $2,000
Multiply the number of other dependents by $500
Add the amounts above and enter the total here
Other Income
Other Deductions
Extra Withholding
- I had no tax liability last year
- I do not expect to have tax liability this year
- Withholding Exempt
If your state requires a W4 State form, return to the home page and fill out the state form AFTER this form is submitted.

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.
I attest, under penalty of perjury, that I am (check one of the following boxes):
*
- A citizen of the United States
- A noncitizen national of the United States
- A lawful permanent resident (see below)
- An alien authorized to work
Alien Registration Number/USCIS Number:
An alien authorized to work until (See instructions) (expiration date, if applicable)
Form I-94 Admission Number (if applicable)
Foreign Passport Number: (if applicable)

Digital Signature

You Are Consenting to sign this form electronically by typing your name and dating it.
Type Your Name*
Today's Date*