TinyTERM Document - Carpenter Contractors of America

TinyTERM Document - Carpenter Contractors of America

Application
For Employment
We consider applicants for all positions without regard to race, color, religion, sex, national origin,
age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or
any other protected status.
PLEASE PRINT
Date of application: ________________
Position(s) Applied For: _________________________________________________
Referral Source:
Advertisement
Friend
Relative
Walk – In
Employment Agency
Other _____________________________
Name: _____________________________________________________________
LAST
FIRST
MIDDLE
Address: ___________________________________________________________
NUMBER
STREET
CITY
STATE
ZIP CODE
Telephone: __________________ Social Security Number _____________________
If employed and you are under 18, can you furnish a work permit?
Yes
No
Have you filed an application here before?
Yes
No
Have you ever been employed here before?
Yes
No If yes, give date ________________
Are you employed now?
Yes
No
If yes, give date ________________
May we contact your present employer?
Yes
No
Are you prevented from lawfully becoming employed in this country because of Visa or
Immigration status?
Yes
No (Proof of citizenship or immigration status will be required upon employment)
On what date would you be available for work? _______________________________________
Are you available to work:
Full Time
Part Time
Are you on a lay-off and subject to recall?
Yes
Can you travel if a job requires it?
No
Yes
No
Shift work
Temporary
Have you been convicted of a felony within the last 7 years?
Yes
No
(Conviction will not necessarily disqualify applicant from employment.)
If Yes, please explain ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Are you a Veteran of the U. S. Military service?
Yes
No
If Yes, Branch ____________
Please indicate languages you speak, read and/or write.
FLUENT
GOOD
FAIR
SPEAK
READ
WRITE
List professional, trade, business or civic activities and offices held. (You may exclude
memberships which would reveal sex, race, religion, national origin, age, ancestry, or handicap
or other protected status): _________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Give name, address and telephone number of three references who are not related to you and are
not previous employers.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Special Employment Notice to Disabled Veterans, Vietnam Era Veterans, and Individuals With Physical
Or Mental Handicaps.
Government contractors are subject to 38 USC 2012 of the Viet Era Veterans Readjustment Act of 1974
which requires that they take affirmative action to employ and advance in employment qualified disabled
veterans of the Vietnam Era, and Section 503 of the Rehabilitation Act of 1973, as amended, which
requires government contractors to take affirmative action to employ and advance in employment
qualified handicapped individuals.
If you are a disabled veteran, or have a physical or mental handicap you are invited to volunteer this
information which will be treated as confidential. Failure to provide this information will not jeopardize
or adversely affect your consideration for employment.
If you wish to be identified, please sign below.
Handicapped Individual
Disabled Veteran
Vietnam Era Veteran
Signed ___________________________
Employment Experience
Start with your present or last job. Include military service assignments and volunteer activities.
You may exclude organization names which indicate race, color, religion, gender, national
origin, handicap or other protected status.
Employer
Telephone
Dates Employed
Address
From
Work Performed
To
Job Title
Supervisor
Hourly Rate/Salary
Start:
Reason for Leaving
Employer
Telephone
Final:
Dates Employed
Address
From
Work Performed
To
Job Title
Supervisor
Hourly Rate/Salary
Reason for Leaving
Employer
Start:
Telephone
Final:
Dates Employed
Address
From
Work Performed
From
Job Title
Supervisor
Hourly Rate/Salary
Reason for Leaving
Employer
Start:
Telephone
Start:
Dates Employed
Address
From
Work Performed
From
Job Title
Supervisor
Hourly Rate/Salary
Reason for Leaving
Start:
Start:
If you need additional space, please continue on a separate sheet of paper.
Special Skills and Qualification
Summarize special skills and qualifications acquired from employment or other experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Education
Elementary
High
College/University
Graduate/ Professional
School Name
Years
Completed/Degree
4
5
6
7
8
9
10
11
12
1
2
3
4
1
2
3
4
Diploma/Degree
Describe Course of Study:
Describe Specialized
Training, Apprenticeship,
Skills and Extra-Curricular
Activities
Honors Received: State any additional information you fell may be helpful to us in considering your application.
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Applicant’s Statement
I certify that answers given herein are true and complete to the best of my knowledge.
I authorize investigations of all statements contained in this application for employment as may be
necessary in arriving at the employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days.
Any applicant wishing to be considered for employment beyond this time period should inquire as to
whether or not applications are being accepted at that time.
The applicant understands that neither this document nor any offer of employment from the employer
constitute an employment contract unless a specific document to that affect is executed by the employer
and employee in writing.
In the event of employment, I understand that false or misleading information given in my application or
interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and
regulations of the employer.
_______________________________ ________
Signature of Applicant
Date
For Personnel Department Use Only
Arrange Interview:
Yes
No
Remarks:
_____________________________________________________________________________________
_____________________________________________________________________________________
Interviewer(s) ________________________________________
Employed:
Yes
No
Date ________________________
If “Yes”, Date of Beginning Employment ___________________
Job Title ________________________ Hourly Rate/Salary ____________ Department ______________
By (Name and Title)______________________________________________ Date ________________________
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2-15
PURPOSE - Complete
so that your employer can withhold the correct amount of
State income tax from your pay.
- You may use this form if you intend to claim either:
exempt status, or the N.C. standard deduction and no tax credits or only
the credit for children.
NRA.
- Generally you may claim head of household
status on your tax return only if you are unmarried and pay more than
purposes is the same as for federal tax purposes.
- If you are a nonresident alien you must use Form NC-4
1.
Complete the
allowances you are entitled to claim.
The worksheet is provided for
Your home is maintained as the main household of a child or stepchild
for whom you can claim a federal exemption; and
your spouse’s death.
deductions, federal adjustments to income, N.C. additions to federal
income, and N.C. tax credits. However, you may claim fewer allowances
of the year, a new NC-4 is not required until the next year.
incomes, adjustments, additions, deductions, and credits on the
portion of income, adjustments, additions, deductions, and credits on
www.dornc.com under
individual income tax forms.
11-13
North Carolina Department of Revenue
(Enter zero (0), or the number of allowances from Page 2, line 16 of the NC-4 Allowance Worksheet)
,
(Enter whole dollars)
Head of Household
First Name (USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
M.I.
Last Name
Address
City
County
State
Zip Code (5 Digit)
Country (If not U.S.)
Date
.00
Part I
Answer
.
No
No
No
and enter
additional allowances. Otherwise, enter
as total allowances on Form NC-4, Line 1.
on Form NC-4, Line 1.
No
No
No
No
and enter
additional allowances. Otherwise, enter
as total allowances on Form NC-4, Line 1.
on Form NC-4, Line 1.
No
No
No
and enter
additional allowances. Otherwise, enter
as total allowances on Form NC-4, Line 1.
on Form NC-4, Line 1.
No
No
No
and enter
additional allowances. Otherwise, enter
as total allowances on Form NC-4, Line 1.
on Form NC-4, Line 1.
1
No
No
No
and enter
allowances. Otherwise, enter
{
as total allowances on Form NC-4, Line 1.
on Form NC-4, Line 1.
..................................................... 1. _______________________
................................................................. 2. _______________________
................................................................. 3. _______________________
....................................................................................... 4. _______________________
5.
Add lines 3 and 4
................................................................................................................................................ 5. _______________________
............ 6. _____________________
..........................................................................
______________________
................................................................................................................................................ 8. _______________________
(Do not enter less than zero) .......................................................................................
_______________________
............................................................... 10. _______________________
.. 11. ______________________
................................................................ 12. _______________________
Bailey, Social Security, and Railroad
enter 2.
.............................................................................................................................................13. _______________________
14.
Add lines 10, 12, and 13, and enter the total here .................................................................................................. 14. _______________________
from line 14 that your spouse plans to claim .......................................................................................................... 15. _______________________
............................................................................ 16. _______________________
2
Real estate property taxes
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Federal adjustments to income are the amounts that are deducted from total income claimed on your federal return.
Adjustments to income may include:
Alimony paid
IRA deduction
Student loan interest deduction
Total Federal Adjustments to Income
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Total State Deductions from Federal Adjusted Gross Income
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Total Federal Adjustments to Income and State Deductions from Federal Adjusted
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disposes of property
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3
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Credit for Children
A taxpayer who is allowed a federal child tax credit under section 24 of the Internal Revenue Code is allowed a tax credit
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after January 1, 2003
Tax Credit Carryover from previous years
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4
your
.
0
1000
2
1
1
1
2000
3000
12
6
6
3
4000
5000
5000
6000
22
26
11
13
10
12
5
6
0
1000
2
1
1
1
2000
3000
12
6
6
3
4000
5000
5000
6000
22
26
11
13
10
12
5
6
10000
11000
11000
12000
50
55
25
28
23
25
12
13
5