Fax 790G Collectio Fax 790G Collection, single unit

Page 1 of 2

U .S. Department of Labor

Bureau of Labor Statistics

Data Collection Center

dccaddress2

dcccity2, dccst2 dcczip

Phone: dccphone Fax: faxphone

January 21, 2021

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 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 employment according to the definitions listed on the following page.

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. 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 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.

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

Enter the total number of persons who worked or received pay for any part of the pay period including the 12^th of the month.

Include:	Exclude:
Elected or appointed officials Full-time or part-time employees Trainees Employees on paid vacation Employees on paid sick leave Employees on other paid leave Employees on active duty, if receiving pay from employer	Institution inmates Outside contractors and their employees Pensioners Employees on active duty, if not receiving pay from employer Employees on leave without pay the entire pay period Employees on strike the entire pay period Employees of State and Local school systems

column 2

WOMEN employee count

Enter the number of employees in column 1 who are women.

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
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI
Report #: reptnum State: STC Location: REGlocation UI: ReptUI

We will fax you another form for reporting next month.

Thank You!

February 2018 Fax790G_Col_SINGLE.dot