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ASSURE CARD CLAIM FORM Part 1 EMPLOYEE INFORMATION This section MUST be completed in full by the employee. Employer Name: Employee Name: Mail completed from to: Employee Address: Box No. Apt. No.,
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How to fill out part 1 employee information:

01
Start by providing the employee's full legal name, including their first, middle (if applicable), and last name.
02
Then, enter the employee's contact information, including their current address, phone number, and email address.
03
Proceed to enter the employee's social security number or other identification number, as required by your organization or country.
04
Fill in the employee's date of birth, ensuring accuracy and that it matches official documents.
05
If applicable, provide the employee's gender information as per the designated options.
06
Next, enter the employee's marital status and indicate whether they are single, married, divorced, or widowed.
07
Include the employee's emergency contact information, which should consist of a contact person's name and their relationship to the employee, as well as their phone number.
08
If required, provide the employee's preferred language, as it may be necessary for communication purposes.
09
Finally, review the employee's information for accuracy and completeness before submitting.

Who needs part 1 employee information?

01
Employers or human resources departments typically require part 1 employee information for record-keeping and administrative purposes.
02
Payroll departments need this information to accurately process employee wages and benefits.
03
Government agencies, including tax authorities and social security administrations, may require part 1 employee information for compliance and reporting purposes.
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Part 1 employee information includes details such as employee's name, address, social security number, and eligibility to work in the United States.
Employers are required to file part 1 employee information for all employees hired to work in the United States.
Part 1 employee information can be filled out manually on Form I-9 or electronically using E-Verify system.
The purpose of part 1 employee information is to verify the identity and employment eligibility of all employees.
Part 1 employee information must include employee's name, address, date of birth, social security number, and immigration status.
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