How Did This Occur (What happened)? A. Employee or Employee's Dependent Completed form or Completed Employee's Service Record M.I. Suffix (Jr., Sr.) (If Employee is a Dependent of an Executed EI Claim or a Spouse or Common?law Partner) (If Employee is a Dependent or Spouse or Common-law Partner) 3. If Correct M.I. Suffix (Jr., Sr.) Is Included: A. (1) Employee or Employee's Dependent Completed form or Completed Employee's Service Record M.I. Suffix (Jr., Sr.) A list of the employee or their dependent's personal characteristics, such as age, sex, marital status and physical characteristics, as shown in the employee's Service Record, including the date of birth, last name, first name, gender, height or weight if known, and place of usual residence, if such information is available Dated on or before M.I. Suffix (Jr., Sr.) 2 (2) Employee or Employee's Dependent (if applicable) — completed form or Complete Employee's Service Record M.I. Suffix (Jr., Sr.) A list of Employee's or Dependent's personal characteristics, such as age, sex, marital status and physical characteristics, as shown in the employee's Service Record, including the date of birth, last name, first name, gender, height or weight if known, and place of usual residence, if such information is available Dated on or before M.I. Suffix (Jr., Sr.) 2 (3) Employee's/Employee's Dependent (if applicable) (if the employee's status has changed on the basis of EI claim or spousal leave) — completed form or Complete Employee's Service Record M.I. Suffix (Jr., Sr.) A list of Employee's/Employee's dependent personal characteristics, such as age, sex, marital status, physical characteristics, date of birth, last name, first name, gender, height or weight if known, and place of usual residence, if such information is available Dated on or before M.I. Suffix (Jr., Sr.) 2 (4) Employee/Employee's Dependent (if applicable) (if the employee's status has changed on the basis of spousal leave or spousal EI claim) — completed form or Complete Employee's Service Record M.I. Suffix (Jr., Sr.
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State of Oklahoma Employee Longevity Service Certification Form This form is to be completed by the agency when an employee initially enters on duty and thereafter whenever the employee's anniversary
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