Quick Quote
To send your information click the Submit Request for Services button at the bottom
Please complete the information below. Fields with an * are required.


Contact Information
*Name: 
*Company: 
*Address: 
*City: 
*State:     *Zip: 
*Phone: 
Fax: 
*Email: 
Business Information
Business Industry: 
Other Industry: 
Years in Business: 
Type of Business: 
Pay Period: 
Number of Employees: 
In-House HR Staff Size: 
Website URL: 
What services are you interested in?
Employee Benefits Administration
HR Management
(Employee Handbook, Hiring, Relations, Reviews, Files)
Payroll
Regulatory Compliance
Workers Comp Insurance and Risk Management
Other Services 
When is the best time to contact you?
Day
Night
What employee benefits do you plan to offer?
Have Want
Group Life Insurance
Group Medical Insurance
Group Dental Insurance
Group Vision Insurance
Short-Term Disability
Long-Term Disability
401(k) Programs
Employee Assistance Programs (EAP's)
Flexible Spending
Other 
None
What is your current payroll burden?
15-19%
20-24%
25-29%
Over 30%
Who is currently processing your payroll?
PEO
Payroll Service
In-House
Other 
When would you like to start receiving HR outsourcing services?
ASAP
In two weeks
In one month
In two months
More than two months

Additional Information
In order to put together a thorough proposal, it is likely that a PaySourceUSA Sales Representative will need to contact you to gather additional information. No Pressure. No obligations.