Form OES Fax Form OES Fax Form OES Fax Form

Occupational Employment Statistics Report
In Cooperation with the U.S. Department of Labor

Company Name__________________________________________
IDCF Number____________________________________________
Contact Name___________________________________________
Email__________________________________________________
Phone___________________    Fax_______________________

Instructions:

1) Report part-time workers by their hourly wage rate. Full-time workers can be reported by their annual salary or hourly wage rate.
2) Report each employee by occupational title. Report an employee who works in two or more occupations in the job that requires the highest
skill level. If there is no measurable difference in skill, report the employee in the occupation in which they spend the most time.
3) If you require additional space, please copy this page and submit all pages in your fax.
4) Please fax form back to the fax number listed above.
NUMBER OF EMPLOYEES IN SELECTED WAGE RANGES
(Report annual or hourly rate for full-time workers. Report hourly rate for part-time workers)

Job Title

A

B

C

D

E

F

G

H

I

J

K

L

Hourly

under
$9.25

$9.25 11.99

$12.00 15.49

$15.50 19.74

$19.75 25.49

$25.50 32.74

$32.75 41.99

$42.00 53.99

$54.00 69.49

$69.50 89.49

$89.50 114.99

$115.00
and over

Annual

under
$19,240

$19,240 24,959

$24,960 32,239

$32,240 41,079

$41,080 53,039

$53,040 68,119

$68,120 87,359

$87,360 - $112,320 - $144,560 - $186,160 - $239,200
112,319
144,559
186,159
239,199
and over

(Example):  Registered Nurse

Rev. July 2019

2

1

T
Total
Employment

3

Form Approved

O.M.B. No. 1220-0042