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Employer Information


(e.g. Street, City, State ZIP Code)

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Employee Information


(e.g. Street, City, State ZIP Code)

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Employer operate business


What type of business does the Employer operate?

e.g. (auto mobile, real estate, computer programming)

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Employee's job title & Employee workplace


What will the Employee's job title be?

(e.g. Marketing Assistant)

Where will the Employee work?

(e.g. Street, City, State ZIP Code)

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Employee's job duties


Will the Employee's job duties be specified duties or assigned duties as needed?

Will the Employee's job duties be described in this document or in an attachment?

Will the Employee be responsible for duties NOT specifically mentioned in the Agreement or in the attachment?


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