Test 20240125_202306

SheetJS Table Export

Company Name: Test
Address:
State: MA
Zip Code:
Point of Contact: Email Census to: sales@safeharborsavings.com
Safe Harbor Rep:
Payroll Frequency: Bi-Weekly * Please note any changes to Employee census info will result in changes to estimated savings
First Name Last Name
Email Address
Date of Birth Home State Tax Filing:
Single=I
Married Filling Jointly=M
Married Filling Separately=MS
Head of Household= HH
Approx. Annual Income
(Emp. Only)
Date of Hire Child Dependents Claimed Other Dependents Claimed Health Insurance Premiums PRE-TAX 401(K) Additional Pre-Tax Witholdings (Only Pre-Tax)
Test Test bwol@camcast.net 6/24/68 MA I 60000 6/3/02 4 0 $240.00 $103.00 $67.00

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