Wage Survey Interview Record (Page 2 of 2) in pdf

Wage Survey Interview Record Page 2

OMB Approval: 1205-0017

Expiration Date: 09/30/2016

Wage Survey Interview Record

ETA Form 232A

U.S. Department of Labor

Employment and Training Administration

3. Comments

Describe variables affecting rates, crop conditions or other explanatory and pertinent information:

4. State Workforce Agency Point of Contact

Provide a State Workforce Agency point of contact for the information provided on this form.

Name:

Suzanne Thivierge

Title:

Senior Economic Analyst

Mailing Address:

Maine Dept. of Labor-CWRI

118 State House Station

City:

Augusta

State:

Maine

Zip Code: 04333-0118

Telephone Number (207) 621-5176 /Fax(207) 287-2947

E-mail: Suzanne.P.Thivierge@Maine.gov

Employer Contact

Name: _________________________________________

Date: __________________________________________

Telephone: _____________________________________

E-mail: ________________________________________

Fax: ___________________________________________

Website: _______________________________________

Page 2 of 2

Revised (09/2013)

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Wage Survey Interview Record Page 2