Schedule ET
Rev. 03.99
List of Salaries or Income Advances Earned for
Ordinary Members
_____
During the Taxable Year
YEAR
Type of Industry or Business________________________
Taxable year beginning on ___________ , ____ and ending on __________ , ____
Taxpayer's Name
Employer's Identification Number
Ordinary Member Name
Social Security
Beginning date of
Classification
Salary or income advance
Number
employment
(N=New)
earned during the
(E=Existent)
taxable year
TOTAL