515-309-2950

EMPLOYEE AND EMPLOYER FORMS

Employee Forms

Click on the ‘+’ sign to expand the selection choices.

Direct Deposit

Please complete the appropriate Direct Deposit Form if you wish to use your financial institution for direct deposit of distributions.

 

Dash Payment/Debit Card Application

If you do not have a financial institution or you want your approved distsributions to be direct deposited to a payment card, please complete the following application to apply for the payment card. Not all applicants will be issued a payment card. The issuing bank has final approval.

Para acceder al formulario en español, haga clic en la esquina superior derecha del formulario para cambiarlo de inglés a español

 

1099-Misc - Request Duplicate(s)

To request a duplicate 1099-MISC, please complete the following form.

Para acceder al formulario en español, haga clic en la esquina superior derecha del formulario para cambiarlo de inglés a español

 

W-9 Forms

If you were requested by NeuBridg to provide IRS Form W-9, please click on the below link to complete the request.

You will need to download the form. Once downloaded you can complete the form and press the green ‘SUBMIT’ button in the lower left corner.

 

Quit or Terminated Employees

Those employees who quit or were terminated from their employer and are requesting a distribution, please click on the link below and follow the instructions.

 

Lifestyles Savings Debit Card Application

To participate in the NeuBridg LSA, each employee must complete the Lifestyle Savings Account application.

 

LSA Electronic Application

Instructions

Employer Forms

Click on the ‘+’ sign to expand the selection choices.

Banking

This is the Master Banking form. By completing this form,  this is the bank and account that NeuBridg will initiate ACH’s from. The Master Banking ACH Banking Form only has to completed once or when the financial institution, or account changes.

The Periodic ACH Request Form MUST be completed each time you request that NeuBridg initiate an ACH. No ACH’s will be initiated, without completion of this form.

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