Various business forms and information for your business.
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Affordable Care Act (ACA) Information:
Navigating the Affordable Care Act Mandate (PDF)
ACA Harris Beach Presentation (PDF)
IRS ACA Reporting Requirement Guidance (Publication 5196 PDF)Here are some additional IRS Links to Information on the Affordable Care Act:
Affordable Care Act Tax Provisions Home Page (Link)
Affordable Care Act Tax Provisions for Employers (Link)
Affordable Care Act Tax Provisions (Link)
Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act (Link)
Health Insurance Tracking form for EE W-2 box 12:
This tracking form is used to assist in obtaining the information that is needed to report the cost of the coverage under an employer-sponsored group health plan.
Payroll Forms:
W-4 Form 2019 (PDF)
I-9 Form (PDF)*
I-9 Form (Non-Interactive PDF)
I-9 Form Instructions (PDF)
New York State IT-2104 Form 2019 (PDF)
W-9 Form Request for Taxpayer ID Number & Certification (PDF)
Employee Profile Form (PDF)
Withdrawal Authorization Form (PDF)
Direct Deposit Authorization Agreement Form (PDF)
Electronic Quarterly Access Letter (CPA Access (PDF)
Bonus Payroll Form (PDF)
NYS Social Security Number Waiver Form (PDF)*I-9 forms are to be maintained and filed together in a separate file (not with employee personnel file information)
Links for NYS Wage Theft Prevention Act Notice Templates (PDFs):
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For additional templates, please refer to the agency website at: https://www.labor.ny.gov/
formsdocs/wp/ ellsformsandpublications.shtm Detailed information on the New York Wage Theft Prevention Act can be found at:
Benefits/Health Forms:
Section 125 Affidavit Dependent Care Costs FSA (PDF)
Sect 125 Plan Premium Conversion Adoption Agreement ER Form (PDF)
Health Savings Account Direct Deposit Form 2018 (PDF)
Health Savings Account Direct Deposit Form 2019 (PDF)
Notice of Exchanges and Subsidies Forms and Information
Employee Health & Dental Deduction Form
Examples of How to Calculate Health Care Deductions
Additional Information:
CPA and Client Instructions to Access Electronic Quarterlies (PDF)
Contact Us
You may contact a USA Payroll Sales Representative at 888-872-2432,
Mon. - Thur. from 8:00 a.m. to 5:00 p.m. ET
Fridays from 8:00 a.m. to 4:00 p.m. ET
Mailing Address:
USA Payroll Inc.
2601 Lac De Ville Boulevard
Rochester, NY 14618