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Get PA DCED CLGS-32-5 2019-2021

Year and Quarter: INCLUDE ONLY W-2 WAGE EARNERS FROM BUSINESS PAYROLL - USE EMPLOYEE STREET ADDRESS (No PO Boxes) (11) EMPLOYEE S SOCIAL SECURITY NUMBER (13) GROSS COMPENSATION PAID THIS QUARTER (12) EMPLOYEE S NAME/ADDRESS Check box if making any corrections to EMPLOYEE S Name/Address, SSN, or Resident PSD $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $ . $.

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