Please complete and submit this notice for any employees being placed on lack of work layoff, that are expected to be recalled to work in the future. Multiple employees can be entered on one form.

Employee Name:
Social Security #:
Date of Hire:
Last Day Worked:
Expected Recall:
   
Employee Name:
Social Security #:
Date of Hire:
Last Day Worked:
Expected Recall:
   
Employee Name:
Social Security #:
Date of Hire:
Last Day Worked:
Expected Recall:
   
 
 
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