C:Documents and SettingsrcpvelaDesktop2009 Probation FormsEmployer Ack Form wpd Income Tax 2026

1. Click ‘Get Form’ to open the Employer Acknowledgment form in the editor.
2. Begin by entering the 'Name of Probationer' and 'Probationer’s Position/Title' in the designated fields.
3. Fill in the 'Date of Hire', followed by the 'Employer Name' and 'Employer Address'. Ensure all information is accurate.
4. Provide the 'Employer Main Telephone' and 'Employer Dept. Telephone' for easy contact.
5. List the current supervisor(s), Respiratory Care Dept. Director, and Hospital Administrator as required.
6. Respond to questions regarding document receipt by selecting ‘YES’ or ‘NO’ for each statement provided.
7. The employer must print their name, title, sign, and date at the bottom of the form to certify completion.
8. Once completed, save your changes and follow instructions to submit directly to the Respiratory Care Board.

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