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Pay Equity Data Entry Form
Current
Information
Pay Equity Data
Complete
Company Name
Mailing Address
Mailing Address
Mailing Address Line 2
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East)
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
ZIP/Postal Code
Phone
E-mail Address
FEIN
Reporting Calendar Year
Any Additional Information
Do you as an employer set wages for any employee based upon
A seniority system
A system that measures earnings by quantity or quality of production
None of the above
* Length of Service on Entry Form should represent the employees' time with the employer. However, it is acceptable to instead use the length of time employees have been in their present job title. Please specify which measure of service is being utilized:
Total Time with Employer
Length of Time in Present Title
Leave this field blank
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