Your Employer Information

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Care Stat Staffing LLC
159-16 Union Turnpike Ste 212 , Fresh Meadows, NY 11366

Your Information










This company participates in various federal and state tax credit programs. This information in no way will negatively impact any hiring or retention decisions. Your responses to the questions will only be shared with your employer's management and federal, state, or local governmental agencies as needed for the administration of these programs. By completing this form, you knowingly and voluntarily waive any objection to providing your social security number. Any information provided will be used in a manner consistent with the Americans with Disabilities Act. Under penalty of perjury, I certify that this information is true and correct to the best of my knowledge. I hereby authorize this company's management and federal, state, and local government agencies to provide information to Tax Opportunities America and/or State Workforce Agencies (SWA), to determine eligibility. I understand that the information above may be subject to verification.

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For any questions, email, or call (718) 705-9003