Test Form-Point Data Unstructured

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Sheet 1: Front

OCCUPATIONAL EMPLOYMENT REPORT

In Cooperation with the

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U.S. Department of Labor

O.M.B. No. 1220-0042

What this report is about: This form asks for information about the occupations and wage ranges of the employees described in Item 3 below. Please complete Items 1 through 5 on this page. Next, please provide the information requested beginning on page 1 for the employees who worked during or received pay for the pay period that included the reference date in Item 3, printed directly above your establishment name. The instructions on pages ii and 1 explain how to provide the information. Please see our website at http://www.bls.gov/OES for more information on the OES Program, including a display of national, state and metropolitan area employment and wage estimates by occupation.

This form asks for information about the employees described below. Our estimate of employment for these employees appears at the top right corner of the label. Please make any needed address corrections.

1

Which of the following options describes the status of the location(s) in Item 3 as of the reference date also printed in Item 3?

3

Operating: Go to item 2.

Temporarily closed during the reference period: Report data only for

employees paid for work during the reference period. If no employees

worked for pay, report "0" in section 4 of this page and return the form

in the reply envelope provided.

Permanently out of business as of __/__/____: Return the form to the

address at the top.

Sold or merged: Enter the new name and address below, then

go to item 2.

4

How many employees, both full and part-time, worked at this location(s) during the pay period that included the reference date printed in Item 3?

New Name: ________________________________________

New Address: ________________________________________

________________________________________

Enter the number here…

2

Our records show that your main products or services are related to those listed below. If they are not, please list your main products or services on the lines provided and continue with the rest of the report.

Include

Do Not Include

w Full or part-time paid workers

w Contractors and temporary agency

w Workers on paid leave

employees not on your payroll

w Workers assigned temporarily

w Unpaid family workers

to other units

w Workers on unpaid leave

w Incorporated firms - paid owners,

w Owners, proprietors, and partners

officers, and staff

of unincorporated firms

w Workers not covered by

unemployment insurance

Do all employees reported above work at one location?

Yes

No…Enter number of locations

5

Please tell us who to contact if we have questions about your data.

FOR OFFICE USE ONLY

Name: _____________________________________________

_________________________________________________________

Title: ______________________________________________

______________________________________________________________

Phone: (_____)______-______Ext._____ Date: ___________

______________________________________________________________

E-mail address: _____________________________________

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Sheet 2: Interior1

Instructions for Reporting by Occupation

Instructions for Reporting Wage Information

h Report employees in the occupations in which they are working, not

For all employees:

in occupations for which they have been trained.

h Please use the hourly and annual wage rate categories to report

For example: An employee trained as an engineer, but working as a drafter,

employees. If wages are not recorded by hour or year (bi-weekly, or

should be reported as a drafter.

monthly for example), convert them into an hourly wage rate.

h For part-time workers, please report the specific hourly wage rate,

h Report each employee only once in the occupation that requires the highest

not an average.

level of skill if the employee performs work in two or more occupations.

h For tip, commission, and piece-rate workers, please estimate the

If there is no measurable difference in skill requirements, report

earnings (base pay plus tips, commissions, or piece rates), and report the

employees in the occupation in which they spend the most time.

appropriate wage.

h For salaried workers who do not work a standard 2080 hours per year

h Use the description of duties along with the job titles to determine where

(40 hours per week), please report wages on an hourly basis. For workers

to place employees. Do not rely on job titles alone.

who are paid an annual salary by contract, such as Airline Pilots, report

their annual salary.

h Report apprentices and trainees in the job for which they are being trained.

h Include and/or exclude from pay as follows:

Report helpers separately because they are not in training for the

occupation they are helping.

Include as pay

Exclude as pay

h Base Rate

h Attendance Bonus

h Relocation Allowance

h Report part-time workers in the job they perform.

h Commissions

h Back Pay

h Tuition Repayments

h Tips

h Draw

h Severance Pay

h Professionals who directly supervise other workers in professional occupations

h Deadheading Pay

h Holiday Bonus

h Shift Differential

should be classified in the same occupation as the workers they supervise.

h Guaranteed Pay

h Holiday Premium Pay

h Stock Bonuses

For example, a drafter that supervises other drafters is classified as a drafter.

h Hazard Pay

h Jury Duty Pay

h Tool Allowance

h Incentive Pay

h Lodging Payments

h Weekend Pay

h Workers in Service, Sales, Office and Administrative, Forestry and Farming,

h Longevity Pay

h Meal Payments

h Uniform Allowance

Production, Maintenance, and Transportation occupations who spend 80

h Piece Rate

h Merchandise Discounts

percent or more of their time performing supervisory duties should be

h Portal-to-Portal Rate

h Nonproduction Bonus

reported as supervisors. Workers with supervisory duties who spend

h Production Bonus

h On-call Pay

less than 80 percent of their time supervising should be reported

h Cost-of-Living Allowance

h Overtime Pay

with the workers they supervise.

h Perquisites

h Profit Sharing Payment

The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. This report is authorized by law, 29 U.S.C. §2. Your voluntary cooperation is needed to make the results of this report comprehensive, accurate, and timely.

*We estimate that it will vary from 30 minutes to 6 hours to complete this report, depending on such factors as the size of the establishment. This includes time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this information. If you have any comments regarding these estimates or any other aspects of this report, including suggestions for reducing this burden, send them to the U.S. Bureau of Labor Statistics, Division of Occupational Employment Statistics (1220-0042), 2 Massachusetts Avenue NE, Suite 2135, Washington, DC 20212. Please do not return your questionnaire to this address. Use the enclosed preaddressed envelope or the address provided at the top of the first page to return your completed questionnaire. You do not have to complete this questionnaire if it does not display a currently valid OMB control number.

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Sheet 3: Body

6

If returning via facsimile, enter the 10 digit Schedule Number (found at the top of the address label on page i):

__ __ __ __ __ __ __ __ __ - __

7

Please use the following pages to report the employees found in your firm. Please write in each unique employee by occupation title. If there are multiple employees with the same occupational title, please list them seperately. Include a short description of duties, their wage, and their wage interval (Annual, Bi-weekly, Hourly, or Other). If Other, please provide a brief explanation. Also indicate if this wage includes tips, as well as the the number of hours the employee worked during the reference week. Refer to page ii for detailed instructions on how to report by occupation and how to determine wages. If additional space is needed to report all of the workers in your establishment, please photocopy this page.

OCCUPATIONAL TITLE AND DESCRIPTION OF DUTIES

Report Part-time Workers According to an Hourly Rate

WAGE OR SALARY

WAGE RATE FREQUENCY

EXPLANATION (If "Other")

HOURS WORKED

TIPS INCLUDED (Yes or No)

EXAMPLE:

Secretaries - Performs administrative duties, typing, and other tasks as needed.

$12.50

O Annual O Bi-weekly O Hourly O Other

35

O Yes

O Bi-weekly

 Hourly

 No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

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Sheet 4: Last

8

If returning via facsimile, enter the 10 digit Schedule Number (found at the top of the address label on page i):

__ __ __ __ __ __ __ __ __ - __

OCCUPATIONAL TITLE AND DESCRIPTION OF DUTIES

Report Part-time Workers According to an Hourly Rate

WAGE OR SALARY

WAGE RATE FREQUENCY

EXPLANATION (If "Other")

HOURS WORKED

TIPS INCLUDED (Yes or No)

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

O Annual

O Yes

O Bi-weekly

O Hourly

O No

O Other

FOR OFFICE USE ONLY

FIPS Code

Schedule Number

NAICS Code

Unit Total Employment

Reviewed By

Date Reviewed

Total Employment

T