Page
U .S. Department of Labor
Bureau of Labor Statistics
Data Collection Center
dccaddress2
dcccity2, dccst2 dcczip
Phone: dccphone Fax: faxphone
Attn: Payroll Manager
Con_Firm2
Con_Address2
Con_City2, Con_State2 Con_Zipcode2
Dear Payroll Manager:
Thank you for providing your employment data to the Current Employment Statistics program. Enclosed is your FAX Report Form. Please fill out the form only for the pay period which includes the 12th of the month and fax it to the fax number provided by duedate2.
Your response to this report is kept confidential and is used to generate monthly estimates of employment levels and changes, average hourly earnings, and average weekly hours. It also contributes to other statistics including state and local unemployment rates, productivity measures, and the gross domestic product (GDP). Be sure to watch for the release of the national employment situation report on the first Friday of each month. Your data are included in this important release.
If any of the information pre-printed on this form is incorrect, or if you have any questions, please contact us at dccphone2.
Sincerely,
signature
dcccntct2
Data Collection Center Manager
This report is authorized by law 29 U.S.C.2. We request your cooperation to make the results of this survey comprehensive accurate, and timely. 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 (44 U.S.C. 3572) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. Per the Federal Cybersecurity Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity screening of transmitted data.
Please note this report is mandatory in New Mexico, under NMAC 11.3.400.428; Oregon, under the Oregon Revised Statute 657.660; in South Carolina, under Section 41-29-120 of the Code of Laws of South Carolina (for firms employing more than twenty individuals); and in Puerto Rico, under State Law 15, Sections 5, 6 and 15, amended and approved on April 14, 1931.
We estimate that it will take an average of 10 minutes to complete this form each month including time to review instructions, search existing data sources, gather and maintain the necessary data, and complete and review this information. If you have any comments regarding these estimates or any other aspects of this survey, send them to the Bureau of Labor Statistics, Division of Current Employment Statistics (1220-0011), 2 Massachusetts Avenue, NE, Washington, DC 20212. You are not required to respond to the collection of information unless it displays a currently valid OMB control number. Form Approved OMB No. 1220-0011.
►Our records show the following information for your firm:
Con_Firm |
Contact: Attn: Payroll Manager2 |
Con_Address |
Tel: con_tel Ext: con_ext |
Con_City, Con_State Con_Zipcode |
Fax: con_fax |
Please fax report to: faxphone2
► Definitions for the Questions on the Next Page
C
The total number of persons who worked or received pay for any part of the pay period that includes the 12th of the month. Include employees who worked only during the school year but received pay for the whole year.
Include: |
Exclude: |
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C
Enter the number of employees from Column 1 who are women.
C
Enter the number of employees from Column 1 who are regular members of the faculty of this institution or school system. Regular members of the faculty are considered to be professional or “certified” employees who have a contractual arrangement (written or otherwise) for one or more years. Faculty Members include principals, teachers, superintendents, administrators, librarians, counselors, and other professional personal instructors including but not limited to ski resort instructors, dance instructors, and martial arts instructors.
MP MF INT |
refer to page 2 for the Column definitions or call dccphone3.
Reference Month/Year: mon1 year1 |
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Employee Count
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Women Employee Count
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Faculty Members
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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Report #: reptnum State: STC Location: REGlocation UI: ReptUI |
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We will send you another form for reporting next month.
Please keep this form to use when the Data Collection Specialist calls you to complete the survey. Thank You!
February 2018 Fax790S.dot
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |