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Form 1095-C
W-2 Forms
New Hires
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Birthday
(Required)
MM slash DD slash YYYY
Last 4 SSN
(Required)
Position
(Required)
Start Date
(Required)
MM slash DD slash YYYY
Training Availability:
Number of Days Training
(Required)
3
5
Date
(Required)
MM slash DD slash YYYY
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Date
(Required)
MM slash DD slash YYYY
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Date
(Required)
MM slash DD slash YYYY
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Date
(Required)
MM slash DD slash YYYY
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Date
(Required)
MM slash DD slash YYYY
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Hiring Manager Name
(Required)
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