Tax + Payroll Intake Page

Below you will find information about sharing your direct deposit information, forms required by State and Federal agencies, and supporting documentation to prove your identity and employment eligibility.

To make this process easier, we have created an instructional guide to assist you. Click the button below for access.

Please ensure that you have the following items and information accessible before proceeding:

1. Taxpayer ID Number: Social Security Number or Employer ID Number
2. Bank or Credit Union Direct Deposit Information: Account Number, Routing Number, Account Type [Checking or Savings], etc.
3. State-Issued Identification Card or Driver’s License [this will satisfy I-9 Form List B requirement for proof of identity]
4. Photo Identification that satisfies I-9 Form List A eligibility to work in the U.S. [If applicable]
5. Documentation that satisfies I-9 Form List C eligibility to work in the U.S. [If you do not have an item from List A]
6. Completed I-9 Form: https://www.uscis.gov/sites/default/files/document/forms/i-9.pdf
7. Completed DE-4 Form: https://edd.ca.gov/siteassets/files/pdf_pub_ctr/de4.pdf
8. Completed W-4 Form: https://www.irs.gov/pub/irs-pdf/fw4.pdf

Important Notice About Using Cash App, Venmo, and Other Financial Apps for Direct Deposit

If you choose to receive your pay via Cash App, Venmo, Chime, or similar financial apps or prepaid cards, you must first enable direct deposit within the app and ensure your account is fully verified. Submitting routing and account numbers without activating direct deposit may result in payment rejection and delays of up to 5 business days while funds are returned to RSS.

To avoid disruptions:

• Confirm your app/account is set up to receive ACH direct deposits
• Use only the official routing/account info provided by the app
• Double-check that your account is active and eligible to receive payroll payments

RSS is not responsible for delays caused by unverified or improperly set up accounts.

Complete the following form to ensure your payroll and tax form distribution is accurate and on time.

Tax & Payroll Intake Form [W2]

Please enable JavaScript in your browser to complete this form.

 This form is for RSS W-2 Workers ONLY. If you are a 1099 Independent Contractor, this is not the form for you. Do not proceed. Please contact HR at HR@RodgersSecuritySolutions.com 

SECTION 1: Your Contact Information

Legal Name *

First

Last

The name listed on your state/federal identification cards/paperwork

Email *

Phone Number *

Secondary Phone [Only include if a different phone number]

Don’t retype the same number as above

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Date of Birth *

Taxpayer ID Number [Social Security Number] *

Enter your taxpayer identification number, which is your social security number

State-Issued Driver's License or Identification Number *

License/ID Card Expiration Date *

SECTION 2: Tax + Employment Eligibility Information

Is your DE-4 Form complete, signed, dated, and ready to upload to this Intake Form? If not, please complete it and then return to this Intake Form

• Yes, I will upload it to this form

Employee’s Withholding Allowance Certificate Complete this form so that your employer can withhold the correct California state income tax from your pay.

Is your W-4 Form complete, signed, dated, and ready to upload to this Intake Form? If not, please complete it and then return to this Intake Form

• Yes, I will upload it to this form

Is your I-9 Form complete, signed, dated, and ready to upload to this Intake Form? If not, please complete it and then return to this Intake Form *

• Yes, I’m uploading to this form
• No, I had tech issues. I will bring in a paper version or request one in-person.

Do you have one item off of List A on Form I-9 to upload? *

• Yes
• No

If you don't have an item from List A, do you have one item off List B and one item on List C of Form I-9 to upload? *

• List B only
• List C only
• List B and C
• No items from Lists B and C

If your documents are not complete and ready to upload to this Intake Form

Don’t proceed. Complete the documents and then return to this form to upload them.

If you proceed with an incomplete form, you must check the applicable boxes indicating you will bring to RSS paper versions of the missing form(s).

Submitting an incomplete form delays processing your payroll information, etc. The Compliance and Payroll teams will reject or flag your submission until you have made corrections.

TROUBLESHOOTING Government Forms

If you are confused because the government forms don’t offer an e-signature option on mobile devices, simply type your name in the signature line and be sure to date the form. Then take a screenshot of the document(s). Upload those screenshots to our Intake Form. Now you and RSS have proof of your submission.

SECTION 3: Upload Your Completed Forms + Supporting Documents

Upload Page 1 of Form DE-4 [Complete, Signed, and Dated] *

Drag & Drop Files, Choose Files to Upload

Your form must be complete and signed in ink, e-Signature, or typed. A screenshot of the completed for is acceptable as long as complete, signed and dated. Failure to provide this information will result in RSS having to withhold the maximum amount required by state law.

Upload Page 1 of Form W-4 [Complete, Signed, and Dated] *

Drag & Drop Files, Choose Files to Upload

Your form must be complete and signed in ink, e-Signature, or typed. A screenshot of the completed for is acceptable as long as complete, signed and dated. If you don’t submit this information we will have to withhold the maximum amount for taxes required by federal law.

Upload Page 1 of Form I-9 [Complete, Signed, and Dated] *

Drag & Drop Files, Choose Files to Upload

Your form must be complete and signed in ink, e-Signature, or typed. A screenshot of the completed for is acceptable as long as complete, signed and dated. Failure to provide this information will result in your inability to be assigned a shift or your continued/future employment with RSS.

Upload Your Forms of Identification From List A or Lists B & C for Form I-9 *

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

You need to provide proof of identity and eligibility to work in the US by either providing an item from List A or by providing one item from List B and one item from List C on Form I-9.

SECTION 4: Information for employees without bank or credit union accounts

To ensure you are paid correctly and on time.

Important Notice About Using Cash App, Venmo, and Other Financial Apps for Direct Deposit

If you choose to receive your pay via Cash App, Venmo, Chime, or similar financial apps or prepaid cards, you must first enable direct deposit within the app and ensure your account is fully verified. Submitting routing and account numbers without activating direct deposit may result in payment rejection and delays of up to 5 business days while funds are returned to RSS.

To avoid disruptions:

• Confirm your app/account is set up to receive ACH direct deposits
• Use only the official routing/account info provided by the app
• Double-check that your account is active and eligible to receive payroll payments

RSS is not responsible for delays caused by unverified or improperly set up accounts.

SECTION 5: No Financial Institution or Payment Processing Card?

If you don’t have a bank/credit union account or an alternative source like CashApp, where you can provide routing and account information for direct deposit.

PAPER CHECK OPTION *

• I need a paper check.
• N/A- I have my banking information

Thank you for letting us know that you require a paper check. Please skip the Financial Institution information below and proceed to the next page to upload your forms and supporting documents

SECTION 6: Financial Institution Confirmation

Confirm you have read the above information and are ready to provide your direct deposit authorization and details *

• Yes, I confirm

SECTION 7: Direct Deposit Authorization

I hereby authorize Rodgers Security Solutions Inc. to deposit any wages, reimbursements, or other payroll payments directly into the bank account listed below. This authorization will remain in effect until I provide written notice of cancellation or change.

I understand and agree to the following:

1. This authorization replaces any previous instructions and remains in effect until revoked by me in writing.
2. I will notify Rodgers Security Solutions immediately if my banking information changes.
3. Rodgers Security Solutions may initiate adjustments (debits or credits) for any entries made in error.
4. I am responsible for verifying deposits and notifying the payroll department of any discrepancies.
5. I understand that my final paycheck may be issued as a paper check at the employer’s discretion.

Financial Institution Name

Account Type

• Checking
• Savings

Routing Number

This is usually a 9-digit number

Account Number

I want 100% of my pay deposited into this account

• Yes

SECTION 8: Upload Additional Documents [Optional]

Miscellaneous File Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Upload any other relevant documents you want to have in your employee file

SECTION 9: Certifications

I understand that questions or concerns about my pay, schedule, or work assignment should be directed to RSS management or HR—not to clients or unrelated third parties, who don't have access to your personnel records. *

• Yes

I understand that any errors or omissions on my forms will delay processing my paperwork *

• Yes

I understand that I must upload to this secure form AND bring in-person either documentation from I-9 List A or two qualified forms of ID from I-9 form Lists B&C to comply with federal law, to be verified by RSS Intake Staff or Command Post Admins *

• Yes

I understand that if I do not provide W-4 and DE-4 information, RSS is required by law to withhold the maximum amount for state and federal taxes, and this action cannot be reversed or refunded once done. *

• Yes

I understand that if I did not include my direct deposit information or select the "Paper check" option, I will be mailed a paper check. *

• Yes

I understand that if I do not provide my I-9 information I will be ineligible to work for RSS, now or in the future, until this information is provided. *

• Yes

I understand that by requiring this information, RSS is complying with California state and US federal laws. *

• Yes

I certify that the information I provided on this form is truthful, accurate, and complete. *

• Yes

Full Legal Name *

Today's Date *

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