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NJ Department of Labor & Workforce Development Payroll ...

SUBMIT form by email: IMPORTANT: For purposes of law, you must also submit this form to the appropriate public body or Certification for Public Works Projectsfor Contractor and Subcontractor s Weekly and Final Certification Name of Contractor or Subcontractor Business Address Project Location Payroll No. Week Ending Date or Final CertificationNJ Department of Labor & Workforce Development Project Name Contract or Project Contractor Registration # Date Wages Due & Paid (mm/dd/yyyy)KEY W= White; B= Black or African American; A= Asian; N= American Indian or Native Alaskan; I = Native Hawaiian or Pacific Islander; M= 2 or MoreMW-562 (9/19) Check if additional sheets b TitleSexRaceSUMOTUWETHFRSAH ourlyM=Male F=Femaleand Addressjourneyman, , carpenter, mason, plumberX=Non-BinaryHoursof PayP ro jec tWeekFICAOOSSOOSSOOSSOOSSSO2.

Other (specify) Other (specify) I, the undersigned, do hereby state and certify: (1) That I pay or supervise the payment of the persons employed by _____ (Contractor or Subcontractor) on the _____ (Project Name & Location) that during the payroll period beginning on (date) _____, and ...

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