Fillable Employee Prole

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Employee Prole

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The Employee Prole form is 1 page long and contains:

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File type: PDF

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#014-02-12
Employee Prole
Hire Date: ...................................... Date Of Birth: .............................................
Last Name: ........................................... MI ................................. First Name: ..........................................
Ssn #: ..................................................... Marital Status: S M
Address 1: ......................................................................................................................................................
City: ....................................................... State: ..................... Zip Code: ......................................................
Federal Dependents: ................ Additional Federal $ ................... % ...................
State Dependents: .................... Additional State $ ........................ % ...................
State Marital Status: S M
Primary Phone: .................................................. Email Address ................................................................
Salary: ........................................ Standard Hrs: .................................... Pay Freq: .....................................
Rate 1: ......................................... Rate 2: ........................................... Rate 3: .............................................
Gender: M F (Check One) Department #: .....................................................................................
WC Code: ....................................
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Employee Prole

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Completed 15 July 2021

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