Week O GI-Weekly ❑ Month !1' Year
To: $ 111
G. Employment and PrevailingWageInformation
Important Note: It is important for the employer to define the place of intended employment ... performed and
the electronic system will accept up to 3 physical locations and prevailingwageinformation. II the employer has received approval from the
Department of Labor to submit this ... Address 2
1A
3. 4. Coun
5. State/District/Territoty* 6. Postal code •
PrevailingWageInformation (corresponding to the place of employment location listed above)
7. Agency which issued prevailingwage