Census Form Groups 150 Employees Relation to Employee 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Date of Birth State Gender COBRA Salary Frequency of Salary (Weekly, 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Relation to Employee' section for each employee listed. Ensure you accurately describe their relationship.
3. Next, enter the 'Date of Birth' for each employee. Use the format specified in the form to avoid errors.
4. Select the 'State' where each employee resides from the dropdown menu provided.
5. Indicate the 'Gender' of each employee by selecting the appropriate option.
6. For COBRA eligibility, mark 'Yes' or 'No' as applicable for each employee.
7. Input the 'Salary' for each employee, ensuring accuracy in reporting their compensation.
8. Finally, choose the 'Frequency of Salary' (Weekly, Monthly, or Annually) that applies to each employee.

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