Form Wyo-790 - Out Of State Employer Questionnaire - Wyoming Department Of Workforce Services

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WYO-790
(June 2016)
Wyoming Department of Workforce Services
Out of State Employer Questionnaire
Complete and return this form to: Employer Services
P.O. Box 2760
Casper, WY 82602 or fax to:
Unemployment Insurance (307) 235-3278
Workers’ Compensation (307) 777-5298
Company Name:
Address:
City State Zip:
Contact Person Name:
Email:
Phone:
1.
Does your company have a Wyoming resident performing services for your company in
Wyoming?
Type of location:
Home
Office
Address:
2. Has your company been awarded the contract for a project in Wyoming?
Yes
No
If Yes:
 What is the project name and location?
 Start Date:
 How long will this project last?
 How long will your company be working at this location?
 Will your company hire Wyoming residents to work on the project?
Yes
No
 Date of first payroll:
 Does your company expect to pay salaries over $10,000 per month for
work performed in Wyoming?
Yes
No
3. Is your company the General Contractor on this project? Yes
No
(Please provide a list of all subcontractors. The list must include name, address and
contact name and phone number for all subcontractors)
****You are responsible to obtain a current Certificate of Good Standing for
Unemployment Insurance for each subcontractor you hire on all Wyoming jobs****

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