Get NJ AA302 2000

Form AA302 Rev. 1/00 NEW JERSEY FACILITY STATE OF NEW JERSEY Division of Contract Compliance Equal Employment Opportunity EMPLOYEE INFORMATION REPORT IMPORTANT- READ INSTRUCTIONS ON BACK OF FORM CAREFULLY BEFORE COMPLETING FORM. TYPE OR PRINT IN SHARP BALLPOINT PEN* FAILURE TO PROPERLY COMPLETE THE ENTIRE FORM MAY DELAY ISSUANCE OF YOUR CERTIFICATE* DO NOT SUBMIT EEO-1 REPORT FOR SECTION B ITEM 11. SECTION A COMPANY IDENTIFICATION 1. FID. NO. OR SOCIAL SECURITY 2. TYPE OF BUSINESS 1. MFG 2. SERVICE 4. RETAIL 5. OTHER 3. WHOLESALE 3. TOTAL NO. EMPLOYEES IN THE ENTIRE COMPANY COUNTY STATE 4. COMPANY NAME 5. STREET CITY 6. NAME OF PARENT OR AFFILIATED COMPANY IF NONE SO INDICATE ZIP CODE 7. CHECK ONE IS THE COMPANY SINGLE-ESTABLISHMENT EMPLOYER 8. IF MULTI-ESTABLISHMENT EMPLOYER STATE THE NUMBER OF ESTABLISHMENTS IN NJ MULTI-ESTABLISHMENT EMPLOYER 9. TOTAL NUMBER OF EMPLOYEES AT ESTABLISHMENT WHICH HAS BEEN AWARDED THE CONTRACT 10. PUBLIC AGENCY AWARDING CONTRACT Official Use Only DATE RECEIVED INAUG*DATE ASSIGNED CERTIFICATION NUMBER SECTION B EMPLOYMENT DATA 11. Report all permanent temporary and part-time employees ON YOUR OWN PAYROLL* Enter the appropriate figures on all lines and in all columns. Where there are no employees in a particular category enter a zero. Include ALL employees not just those in minority/non-minority categories in columns 1 2 3. DO NOT SUBMIT AN EEO-1 REPORT. JOB CATEGORIES ALL EMPLOYEES PERMANENT MINORITY/NON-MINORITY EMPLOYEE BREAKDOWN COL* 1 COL* 2 COL* 3 MALEFEMALE TOTAL MALE FEMALE AMER* NON Cols. 2 3 BLACK HISPANIC INDIAN ASIAN MIN* ASIAN MIN* Officials/ Managers Professionals Technicians Sales Workers Office Clerical Craftworkers Skilled Operatives Semi-skilled Laborers Unskilled Service Workers Total employment From previous Report if any Temporary PartTime Employees The data below shall NOT be included in the figures for the appropriate categories above. 12. HOW WAS INFORMATION AS TO RACE OR ETHNIC GROUP IN SECTION B OBTAINED 1. Visual Survey 2. Employment Record 3. Other Specify 13. DATES OF PAYROLL PERIOD USED From To 14. IS THIS THE FIRST Employee Information Report Submitted 1. YES 2. NO 15. IF NO DATE LAST REPORT SUBMITTED MO. DAY YEAR SECTION C SIGNATURE AND IDENTIFICATION 16. NAME OF PERSON COMPLETING FORM Print or Type SIGNATURE TITLE DATE 17. ADDRESS NO. STREET PHONE AREA CODE NO. EXTENSION WHITE DIV. OF CONTRACT COMPLIANCE CANARY DIV. OF CONTRACT COMPLIANCE DP PINK PUBLIC AGENCY GOLD - VENDOR. TYPE OR PRINT IN SHARP BALLPOINT PEN* FAILURE TO PROPERLY COMPLETE THE ENTIRE FORM MAY DELAY ISSUANCE OF YOUR CERTIFICATE* DO NOT SUBMIT EEO-1 REPORT FOR SECTION B ITEM 11. SECTION A COMPANY IDENTIFICATION 1. FID. NO. OR SOCIAL SECURITY 2. TYPE OF BUSINESS 1. MFG 2. SERVICE 4. SECTION A COMPANY IDENTIFICATION 1. FID. NO. OR SOCIAL SECURITY 2. TYPE OF BUSINESS 1. MFG 2. SERVICE 4. RETAIL 5. OTHER 3. WHOLESALE 3. TOTAL NO. EMPLOYEES IN THE ENTIRE COMPANY COUNTY STATE 4. COMPANY NAME 5. RETAIL 5. OTHER 3. WHOLESALE 3. TOTAL NO. EMPLOYEES IN THE ENTIRE COMPANY COUNTY STATE 4. COMPANY NAME 5. STREET CITY 6. NAME OF PARENT OR AFFILIATED COMPANY IF NONE SO INDICATE ZIP CODE 7. CHECK ONE IS THE COMPANY SINGLE-ESTABLISHMENT EMPLOYER 8. .