Payroll card issuer registration

Pursuant to legislation passed during the 2005 session, payroll card issuers are required to file notice of doing business with the commissioner of the Department of Labor and Industry.

A payroll card issuer is defined as "an employer that issues a payroll card to an employee or a bank or other entity that issues a payroll card to an employee on behalf of the employer."

If your company is issuing payroll cards as a method of paying employees' wages, you must complete the follow registration form.;

Business name:*	(example: ABC Company) business name
D/B/A name:	(example: ABC Company)
Address line 1:*	(example: 443 Lafayette Road North not a P.O. Box ) address line 1
Address line 2:	(example: Suite 300)
City:
State:
Zip Code:*	(example: 55155 or 551551234) zip
Business phone:*	(example: 651 2845000) business area code business phone business area code invalid business phone invalid
Contact name:*	contact name
Contact's phone:*	(example:651 2845000) contact area code contact phone contact area code invalid contact phone invalid
Contact's email:*	contact email invalid email format

* indicates required field
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