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pdfOCCUPATIONAL
EMPLOYMENT
REPORT
(uuuuuu)
In Cooperation with the
U.S. Department of Labor
STATE DEPARTMENT OF LABOR
LABOR MARKET INFORMATION DIVISION, OES
PHONE: 800-555-5505, FAX: 800-555-5555
123 MAIN ST RM 456
CITYVILLE, ST 12345
Form Approved O.M.B. No. 1220-0042
Rev. March 2018
THIS REPORT IS MANDATORY UNDER SECTION 51-1212 OF THE OFFICIAL CODE OF STATE NAME.
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 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 page 2 explain
how to provide the information.
Please see our website at https://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.
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)?
Operating: Go to Item 2.
Temporarily closed during the pay period that included the reference date: 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 in the reply envelope provided.
Sold or merged: Enter the new name and
address in the box to the right, then go to Item 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 in the lower box and continue with the
rest of the report.
||||||||||||||||||||||||||||||||||||||||||||||||||||||| 00 221310 000000000-2
||||||||||||||||||||||||||||||||||||||||||||||||||||||| 0000000000-00006 000 000
ESTABLISHMENTS OPERATING WATER TREATMENT
PLANTS, AND/OR WATER SUPPLY SYSTEMS.
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?
Enter the number here:
Do all employees reported above work at one location?
Yes
No...Enter number of locations:
5
New Name: _______________________________________
New Address: _____________________________________
_____________________________________
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 in the lower box.
IDCF # 00000000000 00 EST. EMP: 150
REFERENCE DATE: MAY 12, 2018 60 221310 JKL
SCHEDULE # 000000000-2
QC# 000003
HUMAN RESOURCES
COMPANY NAME
REPORT FOR: THIS LOCATION ONLY
501 MAIN ST
CAPITAL CITY, ST 12345-6789
Include
• Full- or part-time paid
workers
• Workers on paid leave
• Workers assigned
temporarily to other units
• Incorporated firms – paid
owners, officers, and staff
Exclude
• Contractors and temporary
agency employees not on your
payroll
• Unpaid family workers
• Workers on unpaid leave
• Owners, proprietors, and
partners of unincorporated firms
• Workers not covered by
unemployment insurance
Please tell us who to contact if we have questions about your data.
Name: ______________________________________________________
Title: ________________________________________________________
Telephone: __________________________ Ext._______ Date: _________
Email address: ________________________________________________
FOR OFFICE USE
ONLY
Instructions for Reporting by Occupation
Report employees in the occupations in which they are working, not in occupations for which they have been trained.
For example:An employee trained as an engineer, but working as a drafter, should be reported as a drafter.
Report each employee only once in the occupation that requires the highest level of skill if the employee
performs work in two or more occupations. If there is no measurable difference in skill requirements, report
employees in the occupation in which they spend the most time.
Please provide a description of duties along with the job titles to help us determine where to place employees.
Do not report job titles alone.
Report apprentices and trainees in the job for which they are being trained. Report helpers separately because
they are not in training for the occupation they are helping.
Report part-time workers in the job they perform.
Professionals who directly supervise other workers in professional occupations should be classified in the same
occupation as the workers they supervise. For example, a drafter that supervises other drafters is classified as a drafter.
Workers in Service, Sales, Office and Administrative, Forestry and Farming, Production, Maintenance, and
Transportation occupations who spend 80 percent or more of their time performing supervisory duties should be
reported as supervisors. Workers with supervisory duties who spend less than 80 percent of their time supervising
should be reported with the workers they supervise.
Instructions for Reporting Wage Information
For all employees:
Please use the hourly and annual wage rate categories to report employees. If wages are not recorded
by hour or year (bi-weekly, or monthly for example), convert them into an hourly wage rate.
For part-time workers, please report the specific hourly wage rate, not an average.
For tip, commission, and piece-rate workers, please estimate the earnings (base pay plus tips,
commissions, or piece rates), and report the appropriate wage.
For salaried workers who do not work a standard 2080 hours per year (40 hours per week), please report
wages on an hourly basis. For workers who are paid an annual salary by contract, such as airline pilots,
report their annual salary.
Include and/or exclude from pay as follows:
Include as pay:
• Base rate
• Commissions
• Tips
• Deadheading pay
• Guaranteed pay
• Hazard pay
• Incentive pay
• Longevity pay
• Piece rate
• Portal-to-portal rate
• Production bonus
• Cost-of-living allowance
Exclude as pay:
• Attendance bonus
• Back pay
• Draw
• Holiday bonus
• Holiday premium pay
• Jury duty pay
• Lodging payments
• Meal payments
• Merchandise discounts
• Nonproduction bonus
• On-call pay
•
•
•
•
•
•
•
•
•
•
•
Overtime pay
Perquisites
Profit sharing payment
Relocation allowance
Tuition repayments
Severance pay
Shift differential
Stock bonuses
Tool allowance
Weekend pay
Uniform allowance
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, except in the case of state
and local governments. The BLS publishes statistical tabulations from this report that may reveal the information reported by state and local governments. Upon request,
however, the BLS will hold the information provided by state and local governments on this report in confidence. Per the Federal Cybersecurity Enhancement Act of 2015,
Federal information systems are protected from malicious activities through cybersecurity screening of transmitted data.
We estimate that the time required to complete this report will vary from 10 minutes to 2 hours, depending on factors such 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 Ave NE, Suite 2135, Washington, DC 20212. This report is authorized by law, 29 U.S.C. §2.
We request your cooperation to make the results of this report comprehensive, accurate, and timely. You do not have to complete this questionnaire if it does not display a
currently valid OMB control number. Form Approved, O.M.B. No. 1220-0042.
6
If returning via fax, enter the 10 digit Schedule Number (found on the third line of the address label in Item 3):
__ __ __ __ __ __ __ __ __ - __
7
Please use the following pages to report the employees found in your firm. Please write in each unique occupational title, a
short description of duties, the number of employees found in each wage column, and the total employment for each
occupation. Refer to the 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
NUMBER OF EMPLOYEES IN SELECTED WAGE RANGES
(Report Part-time Workers According to an Hourly Rate)
Hourly (parttime or full-time)
Annual Salary
(full-time only)
A
B
under
$9.25
$9.25 11.74
C
D
E
F
G
H
$11.75 - $14.75 - $18.75 - $24.00 - $30.25 - $38.50 14.74
18.74
23.99
30.24
38.49
48.99
I
J
K
L
$49.00 61.99
$62.00 78.74
$78.75 99.99
$100.00
and over
under $19,240 $24,440 $30,680 $39,000 $49,920 $62,920 $80,080 $101,920 $128,960 $163,800 $208,000
$19,240 - 24,439 - 30,679 - 38,999 - 49,919 - 62,919 - 80,079 -101,919 - 128,959 - 163,799 - 207,999 and over
T
Total
EXAMPLE:
Registered Nurses (RN)-
A
B
C
D
E
F
G
H
I
J
K
L
T
Provide nursing care to sick or injured
patients.
2
4
7
1
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
8
If returning via fax, enter the 10 digit Schedule Number (found on the third line of the address label in Item 3):
__ __ __ __ __ __ __ __ __ - __
OCCUPATIONAL
TITLE AND
DESCRIPTION OF
DUTIES
FOR
OFFICE
USE ONLY
FIPS Code
NUMBER OF EMPLOYEES IN SELECTED WAGE RANGES
(Report Part-time Workers According to an Hourly Rate)
Hourly (parttime or full-time)
Annual Salary
(full-time only)
Schedule Number
A
B
under
$9.25
$9.25 11.74
C
D
E
F
G
H
$11.75 - $14.75 - $18.75 - $24.00 - $30.25 - $38.50 14.74
18.74
23.99
30.24
38.49
48.99
I
J
K
L
$49.00 61.99
$62.00 78.74
$78.75 99.99
$100.00
and over
under $19,240 $24,440 $30,680 $39,000 $49,920 $62,920 $80,080 $101,920 $128,960 $163,800 $208,000
$19,240 - 24,439 - 30,679 - 38,999 - 49,919 - 62,919 - 80,079 -101,919 - 128,959 - 163,799 - 207,999 and over
T
Total
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
A
B
C
D
E
F
G
H
I
J
K
L
T
NAICS Code
Unit Total Employment
Reviewed By
T
Date Reviewed
Total Employment
| File Type | application/pdf |
| File Modified | 2018-03-28 |
| File Created | 2017-11-06 |