Employer

Employer Information

Legal Name of Employer

{{ boolOrString Employer.LegalName }}

Does the Employer have a Trade Name?

{{ boolOrString Employer.HasTradeName }}

{{#if Employer.HasTradeName }}

Trade Name

{{ boolOrString Employer.TradeName }}

{{/if}}

Has the Employer’s name(s) changed since its last application?

{{ boolOrString Employer.LegalNameHasChanged }}

{{#if Employer.LegalNameHasChanged }}

Prior Name(s) of Employer

{{ boolOrString Employer.PriorLegalName }}

{{/if}}

Federal Employer Identification Number (EIN)

{{ boolOrString EIN }}

Physical Address of Employer’s Main Establishment

{{ formatAddress Employer.PhysicalAddress }}

Mailing Address is different from Physical Address

{{ boolOrString Employer.HasMailingAddress }}

{{#if Employer.HasMailingAddress }} Mailing Address of Employer's Main Establishment
{{ formatAddress Employer.MailingAddress }}
{{/if}}

Does the Employer have a Parent Organization?

{{ boolOrString Employer.HasParentOrg }}

{{#if Employer.HasParentOrg }}

Parent Organization Legal Name

{{ boolOrString Employer.ParentLegalName }}

Parent Organization Trade Name

{{ boolOrString Employer.ParentTradename }}

Parent Organization Address

{{ formatAddress Employer.ParentAddress }}

Should mail be sent to Parent Organiation instead of the employer's address?

{{ boolOrString Employer.SendMailToParent }}

{{/if}}

Employer Status

{{ boolOrString Employer.EmployerStatus.Display }}

{{ Employer.EmployerStatusOther }}

Is this employer a local or State educational agency?

{{ boolOrString Employer.IsEducationalAgency }}

{{#if_eq ApplicationType.Display 'Renewal Application' }}

Number of Workers With Disabilities

When did the employer’s most recently completed fiscal quarter end?

{{ formatDateTime Employer.FiscalQuarterEndDate }}

What is the total number of workers with disabilities employed at subminimum wages during the most recently completed fiscal quarter at all establishments and work sites?

{{ boolOrString Employer.NumSubminimalWageWorkers.Total }}

Provide the number of workers with disabilities employed at subminimum wages for the most recently completed fiscal quarter in each of the following categories:

Community Rehabilitation Program (Work Center)

{{ boolOrString Employer.NumSubminimalWageWorkers.WorkCenter }}

Hospital/Residential Care Facility (Patient Workers)

{{ boolOrString Employer.NumSubminimalWageWorkers.PatientWorkers }}

School Work Experience Program (SWEP)

{{ boolOrString Employer.NumSubminimalWageWorkers.Swep }}

Business Establishment

{{ boolOrString Employer.NumSubminimalWageWorkers.BusinessEstablishment }}

{{/if_eq}}

Government Contracts

Does this employer manufacture items for the Federal Government under the Walsh-Healey Public Contracts Act (PCA)?

{{ boolOrString Employer.PCA }}

Does this employer currently hold any contracts covered by the McNamara-O’Hara Service Contract Act (SCA)?

{{ Employer.SCA.Display }}

{{#if_eq Employer.SCA.Display 'Yes' }}

What is the total number of current SCA-covered contracts under which workers with disabilities are employed and earning subminimum wages?

{{ boolOrString Employer.SCACount }}

SCA Wage Determination Attachment

File name(s):

Attachments are included at the end of the PDF.

{{/if_eq}}

Since January 1, 2015, has this Employer entered into a contract for services or concessions with the Federal Government that may be subject to Executive Order 13658 (Establishing a Minimum Wage for Contractors)?

{{ boolOrString Employer.EO13658.Display }}

Additional Questions

Was the employer a representative payee for any worker with disabilities and, as such, received Social Security Benefits such as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) on behalf of that employee during the most recently completed fiscal quarter?

{{ boolOrString Employer.RepresentativePayee }}

{{#if Employer.RepresentativePayee }}

Total number of workers with disabilities for whom the facility was a representative payee during the most recently completed fiscal quarter?

{{ boolOrString Employer.TotalDisabledWorkers }}

{{/if}}

Did the employer take credit for the cost of providing facilities, such as board, lodging, and transportation, toward meeting the minimum wage or subminimum wage obligations during the most recently completed fiscal quarter?

{{ boolOrString Employer.TakeCreditForCosts }}

{{#if Employer.TakeCreditForCosts }}

Which type of deduction(s) did the employer take?

{{/if}}

Is this a request for Temporary Authority by a vocational rehabilitation program administered by a State agency or the U.S. Veterans Administration?

{{ boolOrString Employer.TemporaryAuthority }}