Page 3
DWS-UI
Form1N
Rev.
Use this worksheet to record the total number of employees employed
08/10
per week in the appropriate year.
WORKSHEET
Number of Employees
Number of Employees
Number of Employees
Number of Employees
Week Current Year
Previous Year
Week Current Year
Previous Year
Week Current Year
Previous Year
Week Current Year
Previous Year
1
14
27
40
2
15
28
41
3
16
29
42
4
17
30
43
5
18
31
44
6
19
32
45
7
20
33
46
8
21
34
47
9
22
35
48
10
23
36
49
11
24
37
50
12
25
38
51
13
26
39
52
INSTRUCTIONS
Count each individual in employment who worked for some portion of a day in each week regardless of whether
they were employed at the same moment of time. Volunteer workers are not to be included in the total count
for each week.