Fax 790E Collectio Fax 790E Collection, single unit

Page 3 of 5

U .S. Department of Labor

Bureau of Labor Statistics

Data Collection Center

dccaddress2

dcccity2, dccst2 dcczip

Phone: dccphone

Fax: faxphone

January 24, 2021

Attn: Payroll Manager

Con_Firm2

Con_Address2

Con_City2, Con_State2 Con_Zipcode2

Dear Payroll Manager:

Thank you for providing your employment, payroll and hours 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 12^th of the month and fax it to the fax number provided by duedate2.

For each worksite with a pre-printed CES report number and worksite description, report all columns for All Workers and Nonsupervisory Workers separately. Detailed definitions and instructions are provided below.

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 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.

Please note this report is mandatory in North Carolina, under Section 96-4(i) of the North Carolina Employment Security Law; in Oregon, under the Oregon Revised Statute 657.660; in Washington, under the Revised Code of Washington sections 50.12.010, 50.12.070, and 50.12.1#0; 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.

MP MF INT

►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

Column 1 EMPLOYEE COUNT – All Workers

Total number of persons in this pay group who worked or received pay for any part of the pay period that includes the 12^th of the month.

Include:	Exclude:
Executives and their staff Salaried officials of corporations Full-time and part-time workers Trainees Workers on active duty, if receiving pay from employer Workers on paid sick leave Workers on paid vacation Workers on other paid leave	Outside contractors and their employees Pensioners Proprietors, owners, or partners of unincorporated firms Workers on active duty, if NOT receiving pay from employer Workers on leave without pay for entire pay period Workers on strike for entire pay period Unpaid family members

EMPLOYEE COUNT – Nonsupervisory Workers

Number of “All Workers” defined above who are not supervisory workers. “Nonsupervisory Workers” includes every employee EXCEPT those whose major responsibility is to supervise, plan, or direct the work of others.

Exclude:

• Department heads

• Executives

• Managers

• Officers

• Superintendents

Column 2 WOMEN EMPLOYEE COUNT

Number of “All Workers” as defined above who are women.

Column 3 PAYROLL, EXCLUDING COMMISSIONS

Total gross pay earned during the entire pay period that includes the 12^th of the month. Report separately for “All Workers” and for “Nonsupervisory Workers”.

Report pay BEFORE employee deductions for:

Taxes FICA (Social Security) Health insurance Pay deferral plans such as 401K

Bonds Pensions Unemployment insurance Union dues

Include:	Exclude:
Wages and salaries Paid holidays, vacation, sick leave, and other paid leave Incentive pay Bonuses paid EACH pay period Overtime pay Tips, if included on W-2s Severance, if paid over multiple pay periods `	Commissions Annual pay for unused leave Awards or bonuses not paid each pay period EMPLOYER contributions to pay such as 401K Pay advances, such as vacation pay advances Payments “in kind” Retroactive or back pay Severance, if provided as one payment Travel or work-related reimbursements

Column 4 COMMISSIONS, PAID AT LEAST ONCE A MONTH

Report separately for “All Workers” and for “Nonsupervisory Workers”.

• Report for the most recent complete period for which commissions are available, which might be different from the pay period that includes the 12^th of the month. Enter 0 if none paid for the period or pay group.

• Exclude base pay, drawing accounts, or basic guarantees.

Column 5 HOURS, INCLUDING OVERTIME

Total number of hours for which employees received pay during the entire pay period that includes the 12^th of the month. Report separately for “All Workers” and “Nonsupervisory Workers”.

• Include overtime; stand-by or reporting time; and hours not worked, but for which workers received pay (holidays, vacations, sick leave, etc.).

• Report hours for salaried and commission-only employees based on their standard work week.

• Do not convert overtime or other premium hours to straight-time equivalent hours.

MP MF INT

Each month report your payroll information for the pay period that includes the 12^th of the month. For questions

refer to page 2 for the Column definitions or call dccphone3.

Reference Month/Year: mon1 year1		1 Employee Count	2 Women Employee Count	3 Payroll, Excluding Commissions	4 Commissions	5 Total Hours, including overtime
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Pay Type: pay-type1	All Workers
	Nonsupervisory Workers

We will fax you another form for reporting next month.

Thank You!

790E Aug 2011 Fax790E_Col_SINGLE.dot