Instructions: Simply print out this worksheet and fax along with any additional information required. An AAMPRO consultant will contact you within 24 hours.
Phone: 908.534.1446 / Fax: 908.534.4693
Company Information:

Company Name: ______________________________________ Type of Business: _______________________

Address: _____________________________________________ Phone: ________________________

City: _________________________________________________ State: _____ Zip: __________

Contact Person: _______________________________________ Title: __________________________
Payroll Information:
Num. of Emp's: Full-time: Part-time:
Gross Payroll $

Pay-period Weekly Bi-weekly Semi-monthly Other ________________________

Is Payroll Processed: In-house Payroll Service Payroll Costs: $ __________________
Benefits Information:

Does Your Company Provide?

Health Insurance Dental Insurance Vision Life Insurance L.T. Disability 401 (k)

Section 125 'Pre-Tax' Cafeteria Plan Flex Spending & Dependent Care EAP (Employee Assistance Plan)

Employee Handbooks

Health Carrier: _____________________________ Employer pays: _________ % or $ ________________

Please Include:

  • Workers'Compensation Insurance Declaration Page (required)
  • State Unemployment & disability Rate, UCT-27-Form (required)
  • administration / Payroll Costs / Hours
  • Health Insurance Plan Description and Rates
  • 401(k) information, profit sharing, etc.
  • Most recent payroll worksheet showing gross payrolls
The Small Business Administration (SBA) and the Society for Human Resources Management estimate that small employers with less than 500 employees spend between 3% to 9% of gross payroll on distractions and lost opportunities. This real cost entails the time spent on;
  • Employer Compliance
  • Shopping Insurance
  • Audits
  • Claims
  • Employee Queries
  • Record-Keeping
  • Payroll
  • Personnel Files
  • Tax Filings
  • Costs of turnover
  • Training
  • Downtime
  • Fines
  • Late Fees
  • Legal Fees
  • Penalties
  • Employee Litigation, etc..