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Form Evf 2015-2023
Form.
X________________________________________________________________________________________
Employee’s Signature
__________________________________________
Date
THIS SECTION MUST BE COMPLETED BY THE EMPLOYER
Employer Identification Number (EIN):
EMPLOYEE INFORMATION:
Employee’s Job Title:
Is the above-mentioned employee newly hired:
Yes
No
Employment Start Date: ______/_______/______
EMPLOYMENT INCOME:
HOURLY RATE:
AVERAGE DAILY TIPS:
GROSS PAY:
$
$
$
THE EMPLOYEE:
Receives...
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