Please review and complete the following to indicate your awareness of the Department of Labor Unemployment Insurance regulations.
The Department of Labor requires ARC Personnel to inform you of proper procedures to follow at the end of each temporary assignment. The procedures are as follows.

· I understand that the length of the assignment I am offered may vary, and that pursuant to the Department of Labor Requirements, I must notify ARC Personnel within 48 hours following the completion of my assignment.

· I understand that I need to provide ARC Personnel with any name, address or telephone contact changes both during my employment with ARC Personnel and also for up to one year following my employment with ARC Personnel.

· I understand that failure to do either of the above may result in my unemployment benefits being denied by the State of New Jersey.

Temporary Employee Name:        ____________________                  Social Security Number:____________________________

Address:_________________________________________

_______________________________           ___________
Employee Signature                                      Date