| No. | Social Security Number | Last Name | First Name | Sex (M/F) |
Officer (Y/N) |
Pct Own | Date of Birth (MM/DD/YY) |
Date of Hire (MM/DD/YY) |
Annual W2 Compensation | Total Hrs Worked | Date of Termin. (MM/DD/YY) |
(b) Class & Job Title Job Description |
|---|
T O T A L
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Please list all employees with the actual gross hours worked.
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List all family members including spouse and children of owners with dates of birth (note as family member).
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List all business addresses if there are employees at multiple locations (i.e. address A, B, C etc.).