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Get DoL ETA 9154 2010-2024

S: This Self-Attestation Form (SAF) is to be completed, signed, and dated by the new hire only. Employers or consultants submit this SAF to the State Workforce Agency with Form ETA 9061 for each certification request filed. New Hire Name: ___________________________________________________________ Social Security Number: _________________ Date of Birth:_______________________ Employer Name: ___________________________________________________________ Employer Federal ID (EIN) Number: ___________.

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