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SOCIAL SECURITY ADMINISTRATION Form Approved OMB No* 0960-0040 TOE 420 EMPLOYMENT RELATIONSHIP QUESTIONNAIRE FIRM S NAME WORKER S NAME ADDRESS OF FIRM WORKER S SOCIAL SECURITY NUMBER FIRM S FEDERAL EMPLOYER S IDENTIFICATION DATE WORKER S SERVICES PERFORMED FROM TO Note - The term worker refers to the person who performed the services. The term firm refers to the individual corporation partnership association or other type of organization for whom the services were performed* Check type of firm ...

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