YourHRSP | Employee Rehire

Please Provide the Following Information about your Rehire.

Remember you must upload two forms of identification to submit this form.

For a list of acceptable forms of ID please visit - https://bit.ly/3Hk2TFa

Company

Date of Submission

Employee First Name

Employee Last Name

Date of Birth

Social Security Number

Phone

Start Date

Location

Department

Position

Reports to

Pay Rate

2nd Pay Rate (if applicable) *if commission, please provide estimated annual salary

Notes

For a list of acceptable forms of ID please visit -

Form of ID #1 (Please only upload PNG files)

Upload File

Upload supported file (Max 15MB)

Form of ID #2 (Please only upload PNG files)

Upload File

Upload supported file (Max 15MB)

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