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Get Form 266 266a 2009-2024

Er's Signature Employer's Printed Name Date Employer Company Name and Address Phone # Fax # E-mail NOTE: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements or misrepresentations to any Department or Agency of the United States as to any matter within its jurisdiction. Employment Verification (March 2009).

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