GUAM DEPARTMENT OF LABOR
APPLICATION FORGUAM REGISTERED APPRENTICESHIP PROGRAM TAX CREDIT
The following items must accompany this registration form:
USDOL BAT Certificate of RegistrationAffirmative Action Plan (If employing more than 5 apprentices)Residency Verification of Apprentice(s)Completed I-9 Form for Each Apprentice (If applicable)Employment Contract(s)
Name of Employer(Full name of Organization) TelephoneAddress (Number,Street, City and Town, State ZIPCode) Type of FirmNature of Employer’sBusiness ActivityLLCSole Prop.PartnershipCorporation
NAME OFAPPRENTICEOCCUPATIONCOMPLETEDAPPRENTICESHIPCONTRACTRESIDENCY VERIFICATIONI-9 FORM
Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No Yes NoYes NoYes No
For additional space, please attachseparate sheet.
I hereby attest to the information contained on this application, and any attachmentsthereto, and certify that all information is true and correct to the best of my knowledge. ____________________________________________________________________ ________________________ Print NameSignatureDate
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