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Employer Work Info - Employer Detail
Welcome
CIN-665
Employer Work Offer Refusal - Employer Detail
*
Required Information
1.
*
Are you a registered employer with DES?
Yes
No
2.
*
Contact Person First Name
3.
Contact Person Middle Initial
4.
*
Contact Person Last Name
5.
*
Contact Number
-
-
Ext.
6.
E-mail Address
7.
Fax Number
-
-
8.
Employer Account Number
-
9.
FEIN
10.
*
Name of Business
(Must not exceed 200 characters)
