Client Termination Form

Client Information

Required fields are designated with an *

*Company Name:

*Company EHX ID/Jobalign ID (Account #):

*Product Selection:

Applicant Tracking System (ATS)

Onboarding I-9

E-Verify

Work Opportunity Tax Credit

Affordable Care Act (ACA)

WOTC screening of employees will stop, however, already processed WOTC applications will take time to certify for WOTC credit, so we'll continue to request payroll, send you the tax credits and invoice for credits started prior to this termination.

* Will EF complete ACA Reporting through the current tax year?

No

Yes

*Termination Effective Date:

*Main Contact Name:

*Main Contact Title:

*Main Contact Email:

*Main Contact Phone:

*Reason for Termination:

Additional Reason for Termination and/or Feedback:

Submit