Employer Enrollment & Payment Setup

Required fields are marked with * i

Fields with * are required to set up employer accounts and ACH payments.

EFT / EDI Information

If you wish to pay via Electronic Funds Transfer (EFT) / Electronic Data Interchange (EDI), please review the file formatting instructions.

EFT/EDI file format instructions

Employer Information

Please provide the legal company name and primary contact information.

Company Name *

Phone Number *

Phone Extension

Fax

Mailing Address *

City *

State *

Zip *

Federal Employer ID (FEIN) *

Number of Employees*

Primary Contact *

First Name *

Last Name *

Phone *

Email *

Mailing Address *

City *

State *

Zip *

Secondary Contact (optional)

First Name

Last Name

Phone

Payroll Processor Information (optional)

If you use a payroll processor, enter their information here.

Processor Name

Address

City

State

Zip

First Name

Last Name

Phone

Fax

Payment / ACH Information

Choose a payment method and provide bank details if applicable

Payment Method *: ACH Debit & WebCheck & WebEFT / EDI

Select how you would like to make payments

ACH Debit & Web Rec.

Easiest option. Set up automated debits and online payments.

Check & Web

Pay by traditional paper check and use the website for management.

EFT / EDI

Automated batch transfers. See formatting instructions.

Bank Name *

Bank Account Nickname

Account Type *

Routing Number * i

Routing numbers are 9 digits. If your routing number is not recognized, contact Customer Service.

Confirm Routing Number *

Account Number *

Confirm Account Number *

Create Account Login

About Your Login

Your username and password will be automatically generated and emailed to the primary contact email address provided. after you submit this form.