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CONFIDENTIAL - Employee Census Fax Version
Company:

Period  /  /  through  /  / 
Name Pos Sex Own
%		 SS# Date of 
Birth		 Date of 
Hire		 Date of 
Term		ModeCompensation Hours
1.
2.
3.
4.
5.
6.

Mode: A=Annual M=Monthly S=SemiMonthly B=BiWeekly W=Weekly H=Hourly
POS: P=Partner/Principal/Owner K=Key O=Other

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