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REV-420 AS (10-99)(I) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF BUSINESS TRUST FUND TAXES DEPT. 280904 HARRISBURG, PA 17128-0904 EMPLOYEE'S STATEMENT OF NONRESIDENT IN PENNSYLVANIA
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To fill out employer completes information below, follow these steps:

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Start by providing the required personal details such as your full name, address, contact information, and social security number.
02
Next, input your employment history. This includes details about your previous employers, job titles, durations of employment, and a brief description of your responsibilities.
03
Include information about your educational background. Specify the degrees you have obtained, the institutions you attended, and any relevant certifications or training programs completed.
04
If applicable, provide details about any professional licenses or memberships you hold. This may include licenses in specific industries or membership in professional organizations.
05
Mention any awards, honors, or recognitions you have received throughout your career. This could include scholarships, employee of the month awards, or industry-specific accolades.
06
Describe any additional skills or qualifications that are relevant to the position you are applying for. This could be proficiency in specific software programs, foreign language proficiency, or other specialized knowledge.
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Finally, include references from previous employers or colleagues who can vouch for your skills, work ethic, and character. Make sure to include their contact information, relationship to you, and a brief description of how they know you.

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Anyone who is applying for a job or seeking employment may need to fill out employer completes information below. This information is typically required during the application process to provide potential employers with a comprehensive understanding of your background, qualifications, and work experience. It helps employers assess your suitability for the job and make informed hiring decisions.
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Employer completes information below refers to the section of a form or document that specifically needs to be filled out by the employer.
Employers are typically required to fill out the information below on behalf of their employees.
Employers can fill out the information by providing accurate details such as employee's name, position, salary, and other relevant information.
The purpose of this information is to keep records of employees, their positions, salaries, and other important details for compliance and organizational purposes.
Information such as employee’s name, job title, salary, date of hire, and other relevant details must be reported on employer completes information below.
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