Crew Forms for US Citizens and Residents

Dear Crewmember:

AvMar Payroll Services has been engaged by this vessels owner to process crew payroll and insure compliance with US Payroll Tax Law. In order to process your payroll, we will need you to complete the attached forms:

1. Crew Information Sheet

2. Form W-4 Employee’s Withholding Allowance Certificate

3. Form I-9

4. Copy of Passport

1. CREW INFORMATION

Vessel Name

Hire Date

Your Name

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone Number

Email Address

Bank Name

Bank Address

(Please provide at least the state in which you originally opened your account if you do not have the street address)

Account #

Type of Account

ABA/Routing

(Provide the ABA/routing for direct deposit/ACH)

SWIFT/BIC Code

(This is for international wires)

IBAN # (for accounts in UK & Europe)

Annual Salary ($)

Position

Date of Birth

Place of Birth

Marital Status

Nationality

Emergency Contact

Please provide our office with a copy of your passport in addition to all requested forms.

PAYROLL WILL NOT BE PROCESSED UNTIL THE CREW PACKET IS COMPLETED IN ITS ENTIRETY. ALL FORMS MUST BE LEGIBLE.

Thank you! We look forward to working with you!

AvMar is not responsible for delays in pay due to incorrect account information submitted on this form, such as closed accounts, incorrect ABA, etc.

We suggest you or your captain submit this paperwork to AvMar via a secure email.

2. Form W-4 Employee’s Withholding Allowance Certificate

The IRS requires that we have a signed copy of this form for every employee/crewmember. We use this form to determine how much tax will be withheld from an employee’s wages.

All crew must fill out Step 1.

All crew must sign and date Step 5.

If you are Single with no dependents and not simultaneously working at another job, then please only fill out Steps 1 and 5.

If you are Married with no children and your spouse does not work, you will need to complete only Steps 1 and 5.

If you are Married and your spouse works or you have other sources of employment income from a concurrent job, we recommend that you speak to your personal accountant in order to complete Steps 2, 3, and 4. You may also refer to IRS Publication 505 for assistance.

If any of your personal circumstances change during the year (such as marriage, a new child, or other sources of income), it is your responsibility to submit an updated W-4.

Step 1: Enter Personal Information

(a) First name and middle initial(Required)

Last name(Required)

(b) Social security number(Required)

Does your name match the name on your social security card? If not, to ensure you get credit for your earnings, contact SSA at 800-772-1213 or go to www.ssa.gov.

Address(Required)

City or town, state, and ZIP code(Required)

(c)(Required)

Single or Married filing separately

Married filing jointly or Qualifying widow(er)

Head of household (Check only if you’re unmarried and pay more than half the costs of keeping up a home for yourself and a qualifying individual.)

Complete Steps 2–4 ONLY if they apply to you; otherwise, skip to Step 5. See page 2 for more information on each step, who can claim exemption from withholding, when to use the estimator at www.irs.gov/W4App, and privacy.

Step 2: Multiple Jobs or Spouse Works

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following.

(a) Use the estimator at www.irs.gov/W4App for most accurate withholding for this step (and Steps 3–4); or (b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below for roughly accurate withholding; or (c) If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This option is accurate for jobs with similar pay; otherwise, more tax than necessary may be withheld.

TIP: To be accurate, submit a 2022 Form W-4 for all other jobs. If you (or your spouse) have self-employment income, including as an independent contractor, use the estimator. Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job.)

Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job.)

Step 3: Claim Dependents

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

Multiply the number of qualifying children under age 17 by $2,000 $

Multiply the number of other dependents by $500 - $

3. Add the amounts above and enter the total here $

Step 4 (optional): Other Adjustments

4A. Other income (not from jobs). $

If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may include interest, dividends, and retirement income.

4B. Deductions. $

If you expect to claim deductions other than the standard deduction and want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.

4C. Extra withholding. $

Enter any additional tax you want withheld each pay period.

Step 5: Sign Here

Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.

Employee’s signature(Required)

(This form is not valid unless you sign it.)

Date(Required)

Employers Only

Employer’s name and address

First date of employment

Employer identification number (EIN)

Step 2(b)—Multiple Jobs Worksheet (Keep for your records.)

If you choose the option in Step 2(b) on Form W-4, complete this worksheet (which calculates the total extra tax for all jobs) on only ONE Form W-4. Withholding will be most accurate if you complete the worksheet and enter the result on the Form W-4 for the highest paying job.

Note: If more than one job has annual wages of more than $120,000 or there are more than three jobs, see Pub. 505 for additional tables; or, you can use the online withholding estimator at www.irs.gov/W4App.

Step 2(b) 1. Two jobs. $

If you have two jobs or you’re married filing jointly and you and your spouse each have one job, find the amount from the appropriate table on page 4. Using the “Higher Paying Job” row and the “Lower Paying Job” column, find the value at the intersection of the two household salaries and enter that value on line 1. Then, skip to line 3

Step 2(b) 2. Three jobs. 2a. $

Three jobs. If you and/or your spouse have three jobs at the same time, complete lines 2a, 2b, and 2c below. Otherwise, skip to line 3.

Find the amount from the appropriate table on page 4 using the annual wages from the highest paying job in the “Higher Paying Job” row and the annual wages for your next highest paying job in the “Lower Paying Job” column. Find the value at the intersection of the two household salaries and enter that value on line 2a.

Three jobs. 2b. $

Add the annual wages of the two highest paying jobs from line 2a together and use the total as the wages in the “Higher Paying Job” row and use the annual wages for your third job in the “Lower Paying Job” column to find the amount from the appropriate table on page 4 and enter this amount on line 2b.

Three jobs. 2c. $

Add the amounts from lines 2a and 2b and enter the result on line 2c.

Step 2(b) 3. $

Enter the number of pay periods per year for the highest paying job. For example, if that job pays weekly, enter 52; if it pays every other week, enter 26; if it pays monthly, enter 12, etc.

Step 2(b) 4. $

Divide the annual amount on line 1 or line 2c by the number of pay periods on line 3. Enter this amount here and in Step 4(c) of Form W-4 for the highest paying job (along with any other additional amount you want withheld)

Step 4(b)—Deductions Worksheet (Keep for your records.)

Step 4(b) 1. $

Enter an estimate of your 2022 itemized deductions (from Schedule A (Form 1040)). Such deductions may include qualifying home mortgage interest, charitable contributions, state and local taxes (up to $10,000), and medical expenses in excess of 7.5% of your income

Step 4(b) 2. $

Enter:

$19,400 if you’re head of household
$25,900 if you're married filing jointly or qualifying widow(er)
$12,950 if you’re single or married filing separately

Step 4(b) 3. $

If line 1 is greater than line 2, subtract line 2 from line 1 and enter the result here. If line 2 is greater than line 1, enter “-0-”

Step 4(b) 4. $

Enter an estimate of your student loan interest, deductible IRA contributions, and certain other adjustments (from Part II of Schedule 1 (Form 1040)). See Pub. 505 for more information

Step 4(b) 5. $

Add lines 3 and 4. Enter the result here and in Step 4(b) of Form W-4

3. Form I-9 Employment Eligibility Verification

This form is required by the Department of Homeland Security to document that each new employee hired after November 6, 1986 is authorized to work in the United States.

Upon completion of form I-9 we will need you to provide a valid copy of your passport or if you are a resident alien, we will need a copy of your Permanent Resident Card.

Section 1. Employee Information and Attestation

(Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)

Last Name(Required)

(Family Name)

First Name(Required)

(Given Name)

Middle Initial(Required)

Other Last Names Used(Required)

(if any)

Address(Required)

(Street Number and Name)

Apt. Number

City or Town(Required)

State(Required)

ZIP Code(Required)

Date of Birth(Required)

U.S. Social Security Number(Required)

Employee's E-mail Address(Required)

Employee's Telephone Number(Required)

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury, that I am (check one of the following boxes):(Required)

A citizen of the United States

A noncitizen national of the United States (See instructions)

A lawful permanent resident

An alien authorized to work

Aliens authorized to work

Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.

1. Alien Registration Number/USCIS Number:

2. Form I-94 Admission Number:

3. Foreign Passport Number:

Country of Issuance:

Signature of Employee(Required)

Today's Date(Required)

Preparer and/or Translator Certification (check one):

I did not use a preparer or translator.

A preparer(s) and/or translator(s) assisted the employee in completing Section 1.

(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)

I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.

Signature of Preparer or Translator

Today's Date

Last Name

(Family Name)

First Name

(Given Name)

Address (Street Number and Name)

City or Town

State

ZIP Code

Section 2. Employer or Authorized Representative Review and Verification

(Employers or their authorized representative must complete and sign Section 2 within 3 business days of the employee's first day of employment. You must physically examine one document from List A OR a combination of one document from List B and one document from List C as listed on the "Lists of Acceptable Documents.")

Employee Info from Section 1

Last Name

(Family Name)

First Name

(Given Name)

M.I.

Citizenship

Immigration Status

List A

Identity and Employment Authorization

A1. Document Title

A1. Issuing Authority

A1. Document Number

A1. Expiration Date

(if any)

A2. Document Title

A2. Issuing Authority

A2. Document Number

A2. Expiration Date

(if any)

A3. Document Title

A3. Issuing Authority

A3. Document Number

A3. Expiration Date

(if any)

List B

Identity

B. Document Title

B. Issuing Authority

B. Document Number

B. Expiration Date

(if any)

List C

Employment Authorization

C. Document Title

C. Issuing Authority

C. Document Number

C. Expiration Date

(if any)

I attest, under penalty of perjury, that (1) I have examined the document(s) presented by the above-named employee, (2) the above-listed document(s) appear to be genuine and to relate to the employee named, and (3) to the best of my knowledge the employee is authorized to work in the United States.

The employee's first day of employment

(See instructions for exemptions)

Signature of Employer or Authorized Representative

Today's Date

Title of Employer

or Authorized Representative

Last Name of Employer

or Authorized Representative

First Name of Employer

or Authorized Representative

Employer's Business

or Organization Name

Employer's Business or Organization Address

(Street Number and Name)

City or Town

State

ZIP Code

Section 3. Reverification and Rehires

(To be completed and signed by employer or authorized representative.)

A. New Name (if applicable)

Last Name

(Family Name)

First Name

(Given Name)

Middle Initial

B. Date of Rehire

(if applicable)

C.

If the employee's previous grant of employment authorization has expired, provide the information for the document or receipt that establishes continuing employment authorization in the space provided below.

3C. Document Title

3C. Document Number

3C. Expiration Date

(if any)

Attest

I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented document(s), the document(s) I have examined appear to be genuine and to relate to the individual.

Signature of Employer

or Authorized Representative

Today's Date

Name of Employer

or Authorized Representative

Comments

This field is for validation purposes and should be left unchanged.