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SCP - 00001 - Employer Information
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Drag and drop csv file with emails
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Import
The Department of the Treasury
Secure Choice Program
Employer Information
Please provide the requested information below
Business Name
*
Street
*
City
*
State
*
Value is not selected
-- Select one --
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code
*
Federal Employer Identification Number
*
What type of business are you in? (ex. Food Service, Transportation, Healthcare, etc.)
Number of Employees
*
Form field Number of Employees has
Invalid numeric value.
Contact First Name
*
Contact Last Name
*
Contact Email Address
*
Email
form field Contact Email Address
is not in correct form
Contact Phone Number
*
Phone
form field Contact Phone Number
must be in the format: (000) 000-0000
Payroll Provider
Email Address:
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