EDC Affidavit of Residency_Certification FORM
AFFIDAVIT OF EDC BENEFICIARY REGARDING RESIDENCY OF EMPLOYEES (29 V.I.C. Sec 710 (a)) Page 1 of ______ I hereby certify, under penalties of perjury, ________________________________________ an Economic Development Commission beneficiary, that the quarterly listing of the beneficiary employees and other information on pages ______ through ______ which are affixed and made part of this affidavit is a true and complete listing of such information for the quarter ending ______________________________________ *. And further, that identification of employees residency conforms to 29 VIC Section 703(e) of which _____________ ( _________ %) are residents and _____________ ( ______ %) are non-residents; and in accordance with 29 VIC Section 708(h) ______ employees are employed on a full time basis. This report includes __________ new employees of whom ___________ were hired through the V.I. Department of Labor. …
Download the original document · Plain text (TXT) · Browse the archive · How this archive works
Original source: https://usvieda.org/wp-content/uploads/2024/05/EDC-Affidavit-of-Residency_Certification-FORM.pdf
SHA-256 1711aa078bb9af5fc2b46f1ecaaa420bdf8122618e8dd71f2c44c15053c79253
Re-using this document
An instrumentality of the Government of the Virgin Islands. No rights are stated anywhere: the document carries no copyright notice and the body publishes no terms of use. 17 U.S.C. § 105 does not reach territorial government, so nothing makes it public domain by operation of federal law — it publishes as a territorial public record, and we say plainly that the position is unstated rather than settled.
Our description, tagging, arrangement, extracted text and machine transcripts are released under CC0 1.0. We assert nothing about the document itself.
Archive identifier LF-1711aa078bb9
Document text
AFFIDAVIT OF EDC BENEFICIARY REGARDING RESIDENCY OF EMPLOYEES (29 V.I.C. Sec 710 (a)) Page 1 of ______ I hereby certify, under penalties of perjury, ________________________________________ an Economic Development Commission beneficiary, that the quarterly listing of the beneficiary employees and other information on pages ______ through ______ which are affixed and made part of this affidavit is a true and complete listing of such information for the quarter ending ______________________________________ *. And further, that identification of employees residency conforms to 29 VIC Section 703(e) of which _____________ ( _________ %) are residents and _____________ ( ______ %) are non-residents; and in accordance with 29 VIC Section 708(h) ______ employees are employed on a full time basis. This report includes __________ new employees of whom ___________ were hired through the V.I. Department of Labor. CORPORATE OFFICIAL _______________________________________ Name (Print) _______________________________________ Signature _______________________________________ Title (only corporate officer, president, manager or person authorized to act in such a capacity.) _______________________________________ Date (SEAL) WITNESSES 1. _______________________________________ Name (Print) _______________________________________ Signature _______________________________________ Mailing Address 2. _______________________________________ Name (Print) _______________________________________ Signature _______________________________________ Mailing Address (OR A NOTARY PUBLIC MAY BE USED INSTEAD OF TWO WITNESSES) SUBSCRIBED AND SWORN to before me this ________ day of __________________, 20________, ______________________________________ Notary Public ______________________________________ Name-Printed (SEAL) My Commission Expires * Affidavit with employee listing is to be submitted to the Economic Development Commission each quarter in conjunction with a copy of the V.I. Employment Security Agency’s “Employees Quarterly Wage and Contribution Report.” SIGN SIGN SIGN