| Name | Description | Type | Additional information |
|---|---|---|---|
| successiveEmployments | boolean |
None. |
|
| concurrentEmployments | boolean |
None. |
|
| nameOfEmployer1 | string |
None. |
|
| tinEmployer1 | string |
None. |
|
| nameOfEmployer2 | string |
None. |
|
| tinEmployer2 | string |
None. |
|
| taxPayerAuthorizedRepresentative | string |
None. |