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Ohio Union Laborers' Apprenticeship Work Report
Please submit 1 form per month
(*) Indicates Required information
Hitting the back button may result in lost progress
First Name
*
Last Name
*
Last four of your Social
*
Address
*
City
*
State
*
Zip Code
*
Local Union Number
*
83
125
134
245
265
329
423
480
500
530
534
574
639
758
809
860
894
935
1015
1149
1216
1410
Phone #
*
Email
*
Month
*
January
February
March
April
May
June
July
August
September
October
November
December
*
2022
2023
2024
Contractor
*
Project Name
*
Please be specific on the type of work performed. Example: Concrete placement, Mason Tending, Asphalt placement
*
Supervisor
*
Supervisor's phone #
*
Number of hours worked:
*
Did you work for more than one contractor this month?
*
No
Yes
Contractor
Job Site
Supervisor
Supervisor phone #
Number of hours worked:
**Please make sure you hit calculate at the bottom of this form
Current Total:
0.00
Calculate