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DOSES 631State of Utah
Department of Workforce Services
Employment Termination Rev. 07/2017Case name:Case number:Employed person:SSN:D10819900500101Please use a black pen to complete form. This form
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What is employed person?
An employed person is someone who has a job and works for an employer.
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Employers are required to file information about their employed persons.
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The purpose of employed person filing is to track employment data for tax and labor law compliance.
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Information such as employee's name, social security number, wages, and taxes withheld must be reported on employed person.
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