Wage Subsidy Claim Form - Department Of Advanced Education And Skills printable pdf download

Wage Subsidy Claim Form - Department Of Advanced Education And Skills

Department of Advanced Education and Skills

Employment and Training Division

LINKAGES

Wage Subsidy Claim Form



Wage Subsidy Claim Form must be signed by both Employee and Employer.



Attach a copy of payroll records.

Project #

__________________________________

Employer Name: _______________________________________________________________

Mailing Address: ________________________________

Telephone # ________________

________________________________

Fax # ______________________

Postal Code:

__________________

E-mail: ___________________________________

PLEASE LIST BELOW THE EMPLOYEE INFORMATION AND WAGES PAID FOR THE CLAIM

PERIOD.

Employee Name: _________________________________

Telephone # _______________

Mailing Address: _________________________________

Fax # ____________________

_________________________________

Postal Code: ______________

Job Title: _______________________________________

Hourly Wage Rate: __________

Start Date of Employment: ________________ Finish Date of Employment: _________________

CLAIM PERIOD

For the Claim Period:

Total # of Hours: __________

Total Gross Wages: ______________

First day worked for the claim period: _______________________________________________

Last day worked for this claim period: _______________________________________________

I / WE CERTIFY THE ABOVE INFORMATION IS TRUE AND CORRECT

Signature (Employee): __________________________

Date: _____________________

Signature (Employer): __________________________

Date: _____________________

Wage Subsidy Claim Form - Department Of Advanced Education And Skills