E-7 ANNUAL SURVEY OF PUBLIC EMPLOYMENT & PAYROLL – Major Spe

State and Local Government Finance and Public Employment and Payroll Forms

e7_2019_OMB

Public Employment & Payroll Forms

OMB: 0607-0585

Document [pdf]
Download: pdf | pdf
Attachment 3
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU
Worksheet

E-7

2019 ANNUAL
SURVEY OF PUBLIC EMPLOYMENT & PAYROLL
March 2019 – Major Special Districts and Agencies
OMB No. 0607-0585: Approval Expires 12/31/2021

(06-28-2018)

DUE DATE:

April 25, 2019
Need help or have
questions?

DO NOT use this worksheet to respond to the survey, it is intended to assist you
with gathering and preparing your data prior to reporting online.
Return to respond.census.gov/aspep when you are ready to report online.

• Visit
respond.census.gov/aspep
• Call
1-800-832-2839 weekdays,
8AM to 5PM ET

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WORKSHEET

Title 13, United States Code, Sections 161 and 182 authorizes the Census Bureau to conduct this collection and to request your voluntary
assistance. These data are subject to provisions of Title 13, United States Code, Section 9(b) exempting data that are customarily provided
in public records from rules of confidentiality.

We estimate this survey will take between 10 minutes to 15 hours to complete, with an average of 50 minutes, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information.

1 Is the addressee title/department and mailing address the same as shown in the address label?
Mark "X" only one box.
Yes – Go to 2

No – Enter correct information below

Addressee Title or Department

ATTN:
Street 1

Street 2

City

State

Zip Code

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This collection has been approved by the Office of Management and Budget (OMB). The eight-digit OMB approval number is 0607-0452 and
appears at the upper right of this page. Without this approval we could not conduct this survey.

Page 2

2

Does this agency currently have paid employees and/or paid officials? Mark "X" only one box.
Yes – go to 3

PART 1 – FULL-TIME EMPLOYEES STANDARD WEEKLY HOURS

3 Approximately how many hours per week do the majority of the full-time employees work?
Include
• Persons paid to work the number of hours that represents regular, full-time employment
• Temporary or seasonal employees who are working the number of hours that represents regular, full-time
employment
Exclude
• Employees on unpaid leave, unpaid officials, pensioners, and contractors and their employees
Mark "X" only one box.
A

40 hours

C

34 to 37.4 hours

E

30 to 31.9 hours

B

37.5 to 39.9 hours

D

32 to 33.9 hours

F

No Full-Time Employees

PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS

4 For each applicable pay period that includes March 12, 2019, what were the TOTAL number of
employees and TOTAL gross payroll amounts for both full-time and part-time employees? Please also
report the number of part-time hours paid for each applicable pay period with part-time employees.
Payroll Codes
W = Weekly;

EXAMPLE

B = Bi-Weekly;

T = Twice a Month;

M = Monthly;

Q = Quarterly;

S = Semi-Annually;

A = Annually

E

If all full-time employees are paid bi-weekly, please provide the one bi-weekly payroll that includes March 12, 2019.

➥

Full-time
Number of
Payroll
Full-time Employees
Code

B

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

1 5 6

2 9 5

M

9

3

2

P

L

If some part-time employees are paid bi-weekly and some part-time employees are paid monthly; please provide the data for
the bi-weekly payroll that includes March 12, 2019 for the employees paid bi-weekly and the monthly data for the month of
March for the employees paid monthly.

A

B. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019

➥

Part-time
Number of
Payroll
Part-time Employees
Code

B
M

X

$Bil.

Gross Payroll for Part-time Employees
Mil.
Thou.
Dol.

Part-time Hours Paid

1 0 3

6 3

0

7

7

2

4

5 5

5

9

0

1 9 8 5

E

1

2 5 2

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A. Full-time employees and gross payroll for the pay period that includes March 12, 2019

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No – go to 5

Page 3
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

A.

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

TRANSPORTATION
1.

Streets and highways

044

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Code
Part-time Employees

Gross Payroll for Part-time Employees
Mil.
Thou.
Dol.
$Bil.

Part-time Hours Paid

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Include
• Employees performing maintenance, repair, construction, and administration of streets, alleys,
sidewalks, roads, highways, bridges, and terminal and dock facilities for public ferries
• Employees performing engineering activities
• Employees performing traffic signal maintenance
Exclude
• Street cleaning employees (should be reported in item 8.)
• Sewer employees (should be reported in item 9.)

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Include
Employees
• Current employees in paid leave status whether paid from the general, special, or Federal grant funds
• All elected or appointed officials paid any amount of pay or stipend (even small amounts of $25 per
meeting or $100 annually) or paid on salary basis; by fees or commissions; on a per meeting basis; or a flat
sum quarterly, semi-annually, or annually
• Temporary or seasonal employees working the number of hours that represent full-time employment should
be reported as full-time employees
• Temporary or seasonal employees working less than the regular, full-time workweek should be reported as
part-time employees
Payroll
• Salaries, wages, fees or commissions, as well as overtime, premium, and night differential pay
• Bonuses and incentive payments that are paid at regular pay periods
• Amounts withheld for taxes, employee contributions to retirement systems, etc.
Hours
• An estimate of hours worked during the pay period for part-time employees, not compensation on an hourly
basis
Exclude
Employees
• Employees on unpaid leave, unpaid officials, pensioners, and contractors and their employees
• School system employees and payrolls
Payroll
• Lump sum payments and the value of living quarters and subsistence allowances furnished to
employees
Do not report
• Cumulative salaries since the beginning of the calendar or fiscal year
• Payroll amounts from last fiscal year
• Employer costs of non-wage employee benefits such as workers’ compensation, FICA, health insurance, etc.

Page 4
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

2.

Airports

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

001

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

3.

Sea and inland port facilities

Part-time Hours Paid

087

of docks, wharves, harbors, piers, and warehouses
regulating the water transportation industry
of facilities for pleasure boats (should be reported in item 10.)
of terminals and dock facilities for public ferries (should be reported in item 1.)

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Include
• Employees
• Employees
Exclude
• Employees
• Employees

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

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Include
• Employees of publicly operated airfields and related facilities
• Airport police and airport firefighters

Page 5
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B.

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

PUBLIC SAFETY
Fire protection
Exclude
• Forest fire protection employees (should be reported in item 11.)
• Rescue squad and emergency medical services employees not part of fire department (should
be reported in item 6.)
a. Firefighters 024
Include
• Persons engaged in fire suppression and prevention
• Employees trained in these activities but performing other duties such as dispatching, emergency
medical care, etc.
• Paid volunteer firefighters (should be reported as part-time employees)
Exclude
• Unpaid volunteer firefighters

(1) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

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4.

(2) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

124

Include
• All fire protection employees not reported in item 4a.
• Fire administrative staff
• If handled by the fire department: Emergency (911) dispatching & emergency medical technicians (EMTs)
c. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

(2) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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b. Other fire protection employees

Part-time Hours Paid

Page 6
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

C.

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

SOCIAL SERVICES AND INCOME MAINTENANCE
Public welfare

079

Include
• Employees performing maintenance of homes and other institutions for the needy
• Nursing home employees and social workers
• Employees performing administration of public assistance and veteran services
• Senior citizen and handicap transportation employees
Exclude
• Hospital employees (should be reported in item 7.)

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Health

Part-time Hours Paid

032

Include
• Public health services and emergency medical services employees
• Mental health and outpatient clinic employees, visiting nurses, and animal control employees
• Alcohol and drug abuse employees
• Employees performing food and sanitary inspections
• Employees performing other environmental health activities (e.g., pollution control)

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Code
Full-time Employees

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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6.

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

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5.

Page 7
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

7.

Hospitals

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

036

Exclude
• Nursing home and welfare institution employees (should be reported in item 5.)

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

D.

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

ENVIRONMENT AND HOUSING
Solid waste management

081

Include
• Recycling, garbage, and refuse collection and disposal employees
• Street cleaning employees
• Employees performing sanitary landfill operations

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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8.

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Include
• Employees of facilities providing inpatient medical care and institutions primarily for care and
treatment of handicapped persons
• Employees of institutions for the custody, treatment or general care of the mentally insane or
emotionally disturbed
• Maternity and children hospital employees

Page 8
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

9.

B = Bi-Weekly;

Sewerage

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

080

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

10. Parks and recreation

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

061

Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Include
• Employees of parks, playgrounds, swimming pools, and golf courses
• Employees of auditoriums, museums, convention centers, and recreational centers
• Employees of marinas, zoos, and gardens
a. Full-time employees and gross payroll for the pay period that includes March 12, 2019

E-7

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Include
• Employees providing maintenance and operation of sanitary and storm sewer systems
• Sewerage disposal plant employees
Exclude
• Water supply employees (should be reported in item 12.)

Page 9
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

11. Natural resources

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

059

Full-time
Number of
Payroll
Code
Full-time Employees

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E.

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

UTILITIES
12. Water supply system

091

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Include
• Employees performing operation, maintenance, and construction of public water supply or
distribution systems

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Include
• Forestry and forest fire protection employees
• Flood control, irrigation and drainage employees
• Agriculture and extension services employees
a. Full-time employees and gross payroll for the pay period that includes March 12, 2019

Page 10
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

13. Electric power system

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

092

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

14. Natural gas supply system

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Include
• Employees performing operation, maintenance, and construction of public electric power supply or
distribution systems

093

Include
• Employees performing operation, maintenance, and construction of public natural gas supply or
distribution systems

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Full-time
Number of
Payroll
Code
Full-time Employees

Page 11
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

15. Transit system

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

094

Exclude
• Employees of transit systems exclusively for handicapped persons or senior citizens (should be
reported in item 5.)

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Include
• Employees performing operation, maintenance, and construction of public mass transit systems,
such as subways, surface rails, and buses

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E-7

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Page 12
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

F.

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

OTHER ACTIVITIES
089

Include
• Employees performing other activities not reported elsewhere
• Employees concerned with elections and voter registration
• Protective inspection and enforcement employees (building, electrical, etc.)
• Motor pool, general public building maintenance, parking facilities, and engineering employees
• Emergency (911) dispatching employees not handled by the fire department
• Employees providing county supervision of public school districts
• Homeland security and emergency magagement employees
Exclude
• School system employees and payrolls

a. Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

(1) Job Function
Specify:

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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c. Please list the major job functions reported above in All other (16a. and 16b.)

Full-time
Number of
Payroll
Full-time Employees
Code

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16. All other

Page 13
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

(3) Job Function
Specify:

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

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(2) Job Function
Specify:

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

(4) Job Function
Specify:

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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Part-time
Number of
Payroll
Part-time Employees
Code

Page 14
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

(6) Job Function
Specify:

(a) Full-time employees and gross payroll for the pay period that includes March 12, 2019
Full-time
Number of
Payroll
Full-time Employees
Code

Gross Payroll for Full-time Employees
$Bil.
Mil.
Thou.
Dol.

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(5) Job Function
Specify:

(b) Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019

E-7

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

Please continue on the next page

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Part-time
Number of
Payroll
Part-time Employees
Code

Page 15
PART 2 – EMPLOYEES, PAYROLL, AND PART-TIME HOURS – (Continued)

W = Weekly;

B = Bi-Weekly;

T = Twice a Month;

Payroll Codes
M = Monthly;
Q = Quarterly;

S = Semi-Annually;

A = Annually

17. TOTAL – (Sum of items 1. through 16.)
Full-time
Payroll
Code

Number of
Full-time Employees

Gross Payroll for Full-time Employees
$Bil.

Mil.

Thou.

Dol.

b. Part-time employees, gross payroll, and hours for the pay period that includes March 12, 2019
Part-time
Number of
Payroll
Part-time Employees
Code

Gross Payroll for Part-time Employees
$Bil.
Mil.
Thou.
Dol.

Part-time Hours Paid

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a. Full-time employees and gross payroll for the pay period that includes March 12, 2019

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E-7

Please continue on the next page

Page 16
PART 3 – REMARKS

5 Use this space for any explanations that may be essential in understanding the reported data.

Please continue on page 10

6 Who should be contacted to answer questions about data reported on this worksheet?
Name of contact person - Please print

Area code and phone number

Email Address - Please print

E-7

Title of contact person - Please print

Extension

Area code and fax number

Date worksheet was completed
(MM)
(DD)
(YYYY)

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PART 4 – CONTACT INFORMATION

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Include
• Any significant changes to employment or payroll occurring within the last year
• Groups of employees for which you were unable to supply information
• A note if the majority of the full-time employees work more than 40 hours per week


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