Headwaters Regional Development Commission - Bemidji, MN

Headwaters Regional Finance Corporation
Semi-Annual Job Report

Name of Company:
Address:
City:
State/Zip:
Contact Person:
Person filling out form:
Telephone Number:
Please complete the information below as of March 31, 2010.
Total Number of Employees: (persons for whom a W-2 or self-employment tax form will be prepared)
Number of Full-Time Employees: (40 hours/week or 2,080 hours/yr)
Number of Part-Time Employees:
Women Employees:
Minority Employees:
Handicapped Employees:
Date:
Your information is needed for loan administrative purposes only and will be kept confidential.