INVOICES plus STATEMENTS ENVELOPES COATS Staffing Software I9 FORMS CLERICAL APPLICATIONS equals... INDUSTRIAL APPLICATIONS The Correct Forms for the Perfect Software! Industry Specific Forms Tailored For COATS
Your COATS Authorized Forms Provider Employee's Withholding Allowance Certificate Form W-4 Department of the Treasury Whether you are entitled to claim a certain number of allowances or exemption from withholding is Internal Revenue Service subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS. 1 Your first name and middle initial Last name Home address (number and street or rural route) City or town, state, and ZIP code OMB No. 1545-0074 2014 2 Your social security number 3 Single Married Married, but withhold at higher Single rate. Note. If married, but legally separated, or spouse is a nonresident alien, check the Single box. 4 If your last name differs from that shown on your social security card, check here. You must call 1-800-772-1213 for a replacement card. 5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5 6 Additional amount, if any, you want withheld from each paycheck.............. 6 $ 7 I claim exemption from withholding for 2014, and I certify that I meet both of the following conditions for exemption. Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and This year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions, write Exempt here............... 7 Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete. Employee s signature AN EQUAL OPPORTUNITY EMPLOYER (This form is not valid unless you sign it.) Date 8 Employer s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.) 9 Office code (optional) 10 Employer identification number (EIN) STATE & FEDERAL LAW PROHIBITS DISCRIMINATION BASED ON AGE. SEX OR NATIONAL ORIGIN For Privacy Act and Paperwork Reduction Act Notice, see page 2. SOCIAL Cat. No. SECURITY 10220Q Form W-4 (2014) NAME: (LAST, FIRST, MIDDLE) NUMBER TOTAL NO. OF INCOME TAX EXEMPTIONS Clerical and Industrial Applications Both COATS SQL and COATS Standard available Spanish versions also available ADDRESS: STREET CITY STATE ZIP HOME TELEPHONE ALT. TELEPHONE CITY & STATE OF BIRTH RIGHT TO WORK IN U.S. ALIEN REG. # ALIEN REG. EXP. SMOKING ENVIRONMENT EMAIL ADDRESS YES NO YES IN CASE OF EMERGENCY, NOTIFY - NAME: ADDRESS TELEPHONE AN EQUAL OPPORTUNITY EMPLOYER STATE & FEDERAL LAW PROHIBITS WHAT POSITION ARE YOU APPLYING FOR? AVAILABLE TO WORK MINIMUM RATE PER HOUR HAVE YOU EVER BEEN CONVICTED HOW DID YOU HEAR OF US? DISCRIMINATION BASED ON AGE. OF A FELONY? YES NO $ /HR. SEX OR NATIONAL ORIGIN WHICH DAYS ARE YOU AVAILABLE TO WORK FULL TIME CITIES AVAILABLE TO WORK IN NAME: (LAST, FIRST, MIDDLE) SOCIAL SECURITY NUMBER TOTAL NO. OF INCOME AVAILABLE LONG TERM ASSIGNMENT 1ST SHIFT AVAILABLE TO WORK FROM: TAX EXEMPTIONS WILL ACCEPT SAME DAY ASSIGNMENT ADDRESS: 2ND SHIFT STREET A.M. TO A.M. TEMP CITY TO HIRE STATE ZIP HOME TELEPHONE ALT. TELEPHONE MON TUE WED THU FRI SAT SUN 3RD SHIFT CAR AVAILABLE? YES NO P.M. TO P.M. RESUME ATTACHED? YES NO CITY & STATE OF BIRTH RIGHT TO WORK IN U.S. ALIEN REG. # ALIEN REG. EXP. SMOKING ENVIRONMENT EMAIL ADDRESS WORK SKILLS - CHECKS YOUR SKILLS AND KIND OF WORK YOU HAVE DONE. TEST RESULTS YES NO YES NO TYPING - APPROX. DATA ENTRY: speed errors % BUSINESS MACHINES: CLERICAL: COMPUTERS: WPM SPEED W.P.M. IN CASE OF EMERGENCY, NOTIFY - NAME: ADDRESS Types Of Computers: MAIN MINI TELEPHONE ALPHA Filing MAC PC LTR NUMERIC Adding Machines Alpha Numeric Coding ALPHA Memory WHAT POSITION ARE YOU APPLYING FOR? AVAILABLE TO STENOGRAPHIC: WORK MINIMUM RATE PER HOUR HAVE YOU EVER BEEN CONVICTED HOW DID YOU HEAR OF US? NUM RECEPTIONIST: Full 10 Key Touch Posting Other Approx. Speed W.P.M. OF A FELONY? YES NO Manual Bulk Mail 10 KEY # Of Incoming Lines Fax Legal Steno $ /HR. Electric WHICH DAYS ARE YOU AVAILABLE TO WORK Telemarketing FULL TIME CITIES AVAILABLE Medical Steno TO WORK IN SOFTWARE PACKAGES: Postage Meter AVAILABLE LONG TERM ASSIGNMENT Selectric # Of Extensions Customer Service Transcribing Machines 1ST SHIFT AVAILABLE TO WORK FROM: WILL ACCEPT SAME DAY ASSIGNMENT Calculators 2ND SHIFT A.M. TO A.M. TEMP TO HIRE Stencils and Kinds MON TUE WED BOOKKEEPING: THU FRI SAT SUN 3RD SHIFT CAR AVAILABLE? YES NO P.M. TO P.M. RESUME ATTACHED? YES NO Masters Full Charge Assistant OTHER: FOREIGN LANGUAGES: Speak Statistical Typing SOFTWARE PACKAGES: WORK SKILLS - Check your skills Accts. and kind Pay. of work Manual you have done. Read CLERICAL # WRONG Accts. Rec. Computer Write SUPPLIES AVAILABLE Driver s License? Invoicing & Billing 1ST 3RD GENERAL Bookkeeping FACTORY / Machines MAINTENANCE EQUIPMENT WAREHOUSE Hard Hat Yes No 2ND 4TH Steno OTHER SPECIAL SKILLS & EXPERIENCES: Carpenter Construction Collections Mechanical Payroll Building Repair Truck Computer Skills Tools License Number SPELLING Transcriber Electrician Painter Reconciliations Assembler Taxes Cleaning Backhoe Receiving Glasses PREVIOUS EMPLOYMENT NAME OF EMPLOYER PHONE OR ADDRESS Plumber SUPERVISOR Inventory PAY P/HOUR ElectronicPOSITION Floor Care REASON FOR Tractor LEAVING Shipping Steel Toe Work Boots CDL FROM TO HVAC Mover Assembler Landscaping Outside Fl. Load / Unload Class A Welder Laundry Inspector Lawn Care Crane Hand Jack Class B Solderer Road Const. Packager Hotel Cleaning Drill Forklift OTHER SKILLS - Please list: Demolition Digger/Raker Quality Control Janitorial Saw Standing Supervisor Casual Labor Machine Operator Nail Gun Sitting Mechanic Jack Hammer EDUCATION NAME OF SCHOOL DEGREE GRADUATED? HAVE YOU Validator EVER WORKED FOR OR APPLIED WITH A TEMPORARY SERVICE? YES NO IF YES, PLEASE LIST THE FIRMS AT WHICH YOU WORKED AS A TEMPORARY. Firm Names & Addresses: PREVIOUS EMPLOYMENT NAME OF EMPLOYER PHONE OR ADDRESS SUPERVISOR PAY P/HOUR POSITION REASON FOR LEAVING FROM TO NO I hereby authorize you and all former employers, and others given by me as a reference, to answer all questions and to give all information in connection with this application or in any way concerning me. I agree, if employed by you, that if ever I make claims against you for personal injuries, upon your request I shall submit to drug screens and examinations by physicians of your selection. Your employment of me may be terminated by you at any time without any liability to me except for wages and salary as have been earned by me at the date of such termination. I understand that it is my responsibility to notify you of my availability on a weekly basis at a minimum, and if I do not, I will be considered unavailable for work. SIGNATURE EDUCATION NAME OF SCHOOL DEGREE GRADUATED? HAVE YOU EVER WORKED FOR OR APPLIED WITH A TEMPORARY SERVICE? YES NO IF YES, PLEASE LIST THE FIRMS AT WHICH YOU WORKED AS A TEMPORARY. Firm Names & Addresses: I hereby authorize you and all former employers, and others given by me as a reference, to answer all questions and to give all information in connection with this application or in any way concerning me. I agree, if employed by you, that if ever I make claims against you for personal injuries, upon your request I shall submit to drug screens and examinations by physicians of your selection. Your employment of me may be terminated by you at any time without any liability to me except for wages and salary as have been earned by me at the date of such termination. I understand that it is my responsibility to notify you of my availability on a weekly basis at a minimum, and if I do not, I will be considered unavailable for work. SIGNATURE Window Envelopes for Checks, Invoices, and Statements Security Envelopes available COATS Laser Forms Feature: Your Company Name We agree that if our firm should hire the above named employee within 12 weeks (clerical / industrial) without agreement from Your Company Name we will pay Your Company Name liquidated damages. It is understood that the undersigned will not entrust Your Company Name employees with unattended premises or any part thereof, handling of cash, negotiables or other valuables without written permissions from Your Company Name and then only when an employee s specific duties necessitate such activity. NOTE: 4 HOUR DAILY MINIMUM ON ALL ASSIGNMENTS. Signature below constitutes full acceptance of all information on form. CLIENT - Authorized Signature of Company Representative Sign here: Firm: CLIENT - Please write total hours in words below. WEEK ENDING DAT (SUN) CLIENT REPORT TO EMPLOYEE NAME (PRINT) TIME IN TIME OUT SOCIAL SECURITY NUMBER LESS LUNCH PERIOD TOTAL HOURS Is this employee s assignment completed in full? Yes No SAT. NOT WORKED IMPORTANT SUN. Employer s Name and Address EMPLOYEE MUST SIGN THIS FORM I certify that these hours were worked by me during the week ending shown above, Show hours to nearest 1/4 hour (.25) TOTAL HOURS and were properly verified by an authorized representative of the customer. 1. Be certain front copy is complete and FOR WEEK Employee sign here: legible. Week ending BLUE/Customer date must Copy be - WHITE/Mail indicated Intact ToYour Company Name and the form signed by you. 2. If you have changed your address, notify us immediately. 3. Contact YOUR COMPANY NAME any day you are unable to report for work and also as soon as your assignment is completed or YOUR COMPANY NAME will assume you are not available for work. 4. Use a separate time sheet for each assignment and for each week s work. MON. TUE. WED. THU. FRI. DRAW LINE THROUGH DAYS TO RECEIVE YOUR PAYCHECK, THIS CARD MUST BE RECEIVED BY YOUR COMPANY NAME NO LATER THAN MONDAY AT 5:00 P.M. YOUR COMPANY NAME YOUR ADDRESS YOUR ADDRESS USE LETTER POSTAGE MAIL IMMEDIATELY TO INSURE PROPER PAYMENT Your company logo Various type styles Your choice of custom ink colors Guaranteed software compatibility Professional in-house graphics Rush order services available Time Cards 2, 3 and 4 part available 5. If desired you may fax your signed time card to: 123-4567. Please call our office to confirm your fax was successfully received. Call Toll Free 1.877.913.8500 Fax 1.757.431.0992
, loy s, loy s Your COATS Authorized Forms Provider (999) 999-9999 Fax Laser Invoice with Remit To Stub Payroll & AP Checks COATS SQL THIS DOCUMENT HAS A COLORED BACKGROUND, A MICROPRINT SIGNATURE LINE AND BLEED THRU NUMBERING. Any Bank Name 000001 12-345 AMOUNT 67 $ PAY TO THE ORDER OF MP AUTHORIZED SIGNATURE Laser Statement with Remit To Stub THIS DOCUMENT HAS A COLORED BACKGROUND, A MICROPRINT SIGNATURE LINE AND BLEED THRU NUMBERING. Any Bank Name 000001 12-345 67 AMOUNT $ PAY TO THE ORDER OF AUTHORIZED SIGNATURE MP Payroll & AP Checks COATS Standard Copy B To Be Filed With Employee s OMB No. Copy 2 To Be Filed With Employee s State OMB No. Federal Tax Return 2004 1545-0008 City, or Local Income Tax Return 2004 1545-0008 a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld b Employer ID number b Employer ID number _ 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld Empl er State, Local, o r File Copy 2004 OMB No. 1545-0008 OMB No. Empl er State, Local, o r File Copy 2004 1545-0008 a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld b Employer ID number d Employee s social 5 Medicare security wages number and tips 6 Medicare tax withheld c Employer s name, e Employee s address, name, and ZIP address, code and ZIP code Continuous Work Tickets (999) 999-9999 Fax WORK TICKET CUSTOMER CODE COMPANY NAME TIME NUM OF WORKERS TICKET NUMBER 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a Code 15 State Emplr s state I.D. # 16 State wages, tips, etc. 17 State income tax 15 State Emplr s state I.D. # 16 State wages, tips, etc. 17 State income tax 13 Statutory employee 14 Other 12b Code Form W-2 Wage and Tax Statement This information is being furnished by the Internal Revenue Service. Dept. of the Treasury - IRS Form W-2 Wage and Tax Statement Employer Copy s state 2 To I.D. Be # Filed 16 With State wages, Employee s tips, etc. wages, City, tips, etc. or Local Income 19 Local income Tax Return tax tax 2004 Copy C For EMPLOYEE S RECORDS 2004 OMB 15 State No. State 17 State income (See Notice to Employee on back of Copy B.) 1545-0008 18 Local 20 Locality name b Employer ID number 5 Medicare wages and tips 6 Medicare tax withheld b Employer ID number 5 Medicare wages and tips 12d Code Dept. of the Treasury - IRS FORM L4UPR 6 Medicare tax withheld L4UP JOB CODE JOB SITE OTHER REPORT TO WORK COMP CODE CONTACT PHONE # WORK TICKET COMMENT / PO # FOR OFFICE USE ONLY EMPLOYEE NAME HOURS WORKED (TO 1/4 HOUR) HARD BOOT GLOVES OTHER EQUIPMENT TRANS INITIAL HAT 4 HOUR MINIMUM (PER PERSON) IMPORTANT DO NOT GIVE WORKERS ANY CASH CUSTOMER RETAIN TOP WHITE SIGNED COPY ONLY 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 DO YOU NEED WORKERS TO RETURN? 15 State Emplr s state I.D. # 16 State wages, tips, etc. 17 State income tax 15 State Emplr s state I.D. # 16 State wages, tips, etc. 17 State income tax YES NO NO. OF WORKERS TIME NEEDED Remarks: PRINT NAME AND TITLE Laser W2s and Envelopes Form W-2 Wages and Tax Statement Dept. of the Treasury - IRS This information is being furnished by the IRS. If you are required to file a tax return, a negligence penalty/other sanction may be imposed on you if this income is taxable and you fail to repeort it. Form W-2 Wages and Tax Statement Important Tax Return Document Enclosed Dept. of the Treasury - IRS L4UP Total Hours: AUTHORIZED SIGNATURE CUSTOMER AGREES TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE HEREOF AND CERTIFIES THAT THE LISTED EMPLOYEES HAVE SATISFACTORILY PERFORMED SERVICE FOR HOURS SHOWN. Misc. Tax Forms Also Available www.brothersprintingusa.com
Standard Ink Colors - colors will vary when printed PMS 423 PROCESS BLACK REFLEX BLUE PROCESS BLUE PMS 209 PMS 314 WARM RED PMS 300 PMS 185 PMS 348 PMS 342 PMS 208 PMS 471 PMS 151 PMS 201 PMS 175 PMS 464 PMS 281 Let Brothers Printing Be Your Complete Printing Source! Printing: Invoices Statements Applications Time Cards I9 Forms Employee Handbooks Brochures Business Cards Envelopes Labels - Singles & Rolls Letterhead NCR Sets Business Forms & Machines: Checks - Laser & Continuous Direct Deposit Vouchers Group Time Sheets Presentation Folders Labels - Laser & Continuous Shredders Promotional Products: Pens & Pencils Coffee Mugs Key Chains Post-It Notes Mouse Pads Stress Balls Logo Throws Water Bottles Golf Balls Golf Tees Rulers Plastic Cards Calendar Cards Apparel Shirts - Embroidered Shirts - Silk Screened Call Toll Free 1.877.913.8500 Fax 1.757.431.0992
Ship to address: 3320 Virginia Beach Blvd, Virginia Beach, VA 23452 Phone (757) 431-2656 Fax (757) 431-0992 Toll Free 1-877-913-8500 Bill to address: FORM 250 500 1,000 2,000 3,000 4,000 5,000 INVOICE * $62.30 $93.10 $124.10 $238.58 $342.99 $457.03 $547.00 STATEMENTS * $62.30 $93.10 $124.10 $238.58 $342.99 $457.03 $547.00 CLERICAL APPLICATION* $105.38 $139.75 $195.88 $313.86 $465.06 $617.41 $746.85 INDUSTRIAL APPLICATION* $105.38 $139.75 $195.88 $313.86 $465.06 $617.41 $746.85 I-9 FORM $72.16 $95.07 $136.31 $266.90 $397.48 $528.06 $658.65 REGULAR ENVELOPES * SECURITY ENVELOPES * (for Checks, Invoices, and Statements) $77.55 $84.55 $109.95 $208.33 $123.96 $236.34 $312.50 $393.52 $474.54 $354.51 $449.54 $544.56 QUANTITY ORDERED FORM PRICE CHECKS** Please send a Voided Check and indicate the Starting Number and Color Choice below: Starting # Color 500 $242.35 1,000 $261.60 2,000 $344.09 3,000 $407.44 5,000 $596.09 7,500 10,000 $761.70 $927.18 1500 3000 6000 TIME CARDS - 2 PART* $257.73 $382.59 $726.23 4 - PART ALSO AVAILABLE TIME CARDS - 3 PART* $352.14 $520.25 $1010.42 PLEASE CALL FOR QUOTE WORK TICKETS* PLEASE CALL FOR QUOTE * Prices above are for black imprint only. A $42.00 color charge, per color, is required when using an imprint color other than black. There is NO ADDITIONAL CHARGE for Black Ink. **Check pricing includes any of the standard colors (request a standard ink chart). Also, ADDITIONAL RUN CHARGES APPLY WHEN MORE THAN ONE COLOR IS REQUIRED. ARTWORK CHARGES APPLY. A PREPAYMENT FORM WILL BE SENT UPON ARTWORK APPROVAL. OTHER CHARGES FREIGHT TOTAL SUB TOTAL Once we have approved artwork, we will request credit card information. A charge will be made to the supplied account at that time for all documents ordered, any additional charges (ie: ink and additional color charges) and artwork. Artwork is charged at a rate of $60 per hour, billed on a.25 hour basis. Once your order has been completed and shipped, a second charge will be made to your supplied credit card for exact shipping charges. If you order over $1,000.00 worth of forms, we will print your company logo and information in your choice of one color at no charge! Please call Glenn, Patty, Reanna or Jeana with any questions about ordering your forms: 1.877.913.8500 04/15/16