<h2 style="padding: 10px">
    <strong>
        <center>
            <img
                src="data:image/png;base64,[encoded data, 5604 characters]"
                alt="logo">
        </center>
    </strong>
</h2>
<div style="padding:0 15px;font-family:sans-serif;font-size: 13px;text-align:justify;">
<!--    <h2 style="margin-bottom:4px;"><strong>-->
<!--            <center><u>{company.name}</u></center>-->
<!--        </strong></h2>-->
    <h3><strong>
            <center><em>Employee/Contractor Onboarding</em></center>
        </strong></h3>
    <br>

    <table border="1" cellpadding="5" width="100%" style="border-collapse: collapse;">
        <tr>
            <td colspan="4" style="background-color: #324878; color: white;-webkit-print-color-adjust: exact;"><b>PROFESSIONAL</b></td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Full Legal Name*</b></td>
            <td colspan="3">{Full Legal Name}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Address Line 1*</b></td>
            <td colspan="3">{Address Line 1}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Address Line 2</b></td>
            <td colspan="3">{Address Line 2}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>City*</b></td>
            <td style="width: 25%">{City}</td>
            <td style="width: 25%"><b>State*</b></td>
            <td style="width: 25%">{State}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Zip*</b></td>
            <td style="width: 25%">{Zip}</td>
            <td style="width: 25%"><b>Email*</b></td>
            <td style="width: 25%">{Email}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Cell Phone*</b></td>
            <td style="width: 25%">{Cell Phone}</td>
            <td style="width: 25%"><b>Home Phone</b></td>
            <td style="width: 25%">{Home Phone}</td>
        </tr>
        <tr>
            <td colspan="4" style="border: none"></td>
        </tr>
        <tr>
            <td colspan="4" style="background-color: #324878; color: white;-webkit-print-color-adjust: exact;"><b>IDENTIFICATION
                    INFORMATION <sup style="font-weight: normal">†</sup></b></td>
        </tr>
        <tr>
            <td style="width: 25%"><b>ID Number*</b></td>
            <td style="width: 25%">{Document ID Number}</td>
            <td style="width: 25%"><b>Document Type*</b></td>
            <td style="width: 25%">{Document Type}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Issuing Authority*</b></td>
            <td style="width: 25%;white-space:nowrap">{Document Issuing Authority}</td>
            <td style="width: 25%"><b>Exp. Date*</b></td>
            <td style="width: 25%">{Document Exp. Date}</td>
        </tr>
        <tr style="border: none">
            <td colspan="4" style="border: none"></td>
        </tr>
        <tr>
            <td colspan="4" style="background-color: #324878; color: white;-webkit-print-color-adjust: exact;"><b>DIRECT DEPOSIT /
                    BANK DETAILS <sup style="font-weight: normal">††</sup></b></td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Bank Name*</b></td>
            <td colspan="3">{Bank Name}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Account #*</b></td>
            <td style="width: 25%">{Account #}</td>
            <td style="width: 25%"><b>Routing*</b></td>
            <td style="width: 25%">{Routing}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Re-Type Account #*</b></td>
            <td style="width: 25%">{Re-Type Account #}</td>
            <td style="width: 25%"><b>Account Type*</b></td>
            <td style="width: 25%">{Account Type}</td>
        </tr>
        <tr style="border: none">
            <td colspan="4" style="border: none"></td>
        </tr>
        <tr>
            <td colspan="4" style="background-color: #324878; color: white;-webkit-print-color-adjust: exact;"><b>EMERGENCY CONTACT
                    INFORMATION </b></td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Contact 1 Name*</b></td>
            <td style="width: 25%">{Contact 1 Name}</td>
            <td style="width: 25%"><b>Relationship*</b></td>
            <td style="width: 25%">{Contact 1 Relationship}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Phone*</b></td>
            <td style="width: 25%">{Contact 1 Phone}</td>
            <td style="width: 25%"><b>Email</b></td>
            <td style="width: 25%">{Contact 1 Email}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Contact 2 Name</b></td>
            <td style="width: 25%">{Contact 2 Name}</td>
            <td style="width: 25%"><b>Relationship</b></td>
            <td style="width: 25%">{Contact 2 Relationship}</td>
        </tr>
        <tr>
            <td style="width: 25%"><b>Phone</b></td>
            <td style="width: 25%">{Contact 2 Phone}</td>
            <td style="width: 25%"><b>Email</b></td>
            <td style="width: 25%">{Contact 2 Email}</td>
        </tr>
    </table>
</div>
