Quarterly Survey

ECIDA Quarterly Survey




Project ID Number (from email):

Company:

Section#1: Employment (only for the location that is receiving IDA benefits):

General Job Classifications Number of
Full-Time Employees
(as of 9/30/16)
Number of
Part-Time Employees
(as of 9/30/16)
Average annual/hourly
salary of full-time
employees
Average annual/hourly
salary of part-time
employees
Manager
Professional
Production/Manufacturing
Clerical/Administrative
Other Job Classifications
(please describe below)

Only report employees in one category. Also, include your NYS-45 Quarterly Combined Withholding, Wage Reporting & Unemployment Insurance Return Form for the quarter ending 9/30/16. Do NOT include Part C (Employee Wage & Withholding Information) or any employee names, social security numbers or wages.




For multi-tenant clients only:

Please provide a copy of your tenant listing and complete the following chart (enclose additional sheets if necessary):

Tenant list and additional sheets:


Tenant Name Number/Estimate of
Full-Time Employees
Number/Estimate of
Part-Time Employees

Section #2: Certification:

Name:

Title:

Phone:

Email:

 I certify that the information submitted on this form is correct to the best of my knowledge according to our records as of September 30, 2016.

If any contact information is incorrect, please provide the updated information below:


Additional comments:


Additional attachments:


Please submit your completed survey and the requested documents on or before October 31, 2016.
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