EDRDocument Report

03/23/2022
Dear Rafael,
Thank you for requesting your Employment Data Report. Your Employment Data Report includes all
employment data sent to The Work Number by your employer(s). An important document titled "A Summary
of Your Rights Under the Fair Credit Reporting Act" is also enclosed. Great care has been taken to report this
information correctly. Please help us in achieving even greater accuracy by reviewing all of the enclosed
material carefully.
Verifiers who have procured your data in the past 24 months -

Organization Name: Capital One (VOI Batch)
Date of Request: 06/22/2021
Organization Name: Capital One (VOI Batch)

Date of Request: 06/24/2020
The information provided in this document is an unofficial report, intended for personal use by the employee-
recipient only. It is not intended for verification purposes. Using this document for consumer verification
purposes could constitute a violation of the Fair Credit Reporting Act and result in a monetary fine. If
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If you need further assistance or wish to dispute any information in your Employment Data Report, please
contact our Client Service Center at 866-222-5880 Monday through Friday 8am-7pm CST. Please reference
case number 987229046394. If you wish, you may also contact your employer(s) at the address indicated in
each employment record below.
Sincerely,
The Work Number Service Team
Attachment
MM, MS
987229046394 Page 1 of 15
EMPLOYEE NAME Rafael Ramirez
SSN XXXXX7196
DATE 03/23/2022
Employer Name Employer Code Employer Address

Triumph 3853986 899 Cassatt RoadSuite 210
Berwyn , PA 19312
Information Current as of Employee Name Division

03/18/2022 Rafael A Ramirez
Employment Status Most Recent Start Date Total Time With Employer Job Title Rate of Pay
Active 01/28/1998 24 years , 2 months Mechanical Product Associate-UStep 11 $38.05 Hourly
Original Hire Date Union Affiliation Work Location(Job site)

01/28/1998 ,
Year Base Pay Overtime Commission Bonuses Other Income Total Pay
2022 $16,742.00 $1,144.00 $0.00 $1,000.00 $0.00 $18,886.00
2021 $74,403.25 $2,404.60 $0.00 $4,579.03 $0.00 $81,386.88
Next Projected Last

Date of Pay Increase
Amount of Pay Increase $0.00 $0.00
FEIN Employee Address Employee Phone Number Date of Birth

461826747 327 Cedar Street 07/05/1969
Newington , Connecticut 06111
WORKERS' COMPENSATION
Claim Number Claim Pending
N
INCOME AND DEDUCTIONS

Average Hours Per Pay Period Pay Cycle
0.0 Weekly
PAY PERIOD DETAIL 03/13/2022

Income Withholding
Total Gross Earnings $1,626.00
HISTORICAL PAY PERIOD SUMMARY
987229046394 Page 2 of 15
Pay Period Begin Pay Period End Pay Date Hours Worked Gross Earnings Net
Date Date
03/07/2022 03/13/2022 03/18/2022 40.0 $1,626.00 $866.40
02/28/2022 03/06/2022 03/11/2022 40.0 $1,626.00 $866.42
02/21/2022 02/27/2022 03/04/2022 40.0 $1,626.00 $771.30
02/14/2022 02/20/2022 02/25/2022 40.0 $2,626.00 $1,420.98
02/07/2022 02/13/2022 02/18/2022 40.0 $1,626.00 $866.42
01/31/2022 02/06/2022 02/11/2022 40.0 $1,626.00 $761.48
01/24/2022 01/30/2022 02/04/2022 40.0 $1,626.00 $678.14
01/17/2022 01/23/2022 01/28/2022 32.0 $1,626.00 $773.26
01/10/2022 01/16/2022 01/21/2022 40.0 $1,626.00 $773.26
01/03/2022 01/09/2022 01/14/2022 40.0 $1,626.00 $796.45
12/27/2021 01/02/2022 01/07/2022 0.0 $1,626.00 $736.32
12/20/2021 12/26/2021 12/31/2021 32.0 $1,626.00 $814.47
12/13/2021 12/19/2021 12/24/2021 32.0 $1,300.80 $642.88
12/06/2021 12/12/2021 12/17/2021 40.0 $2,712.44 $1,597.56
11/29/2021 12/05/2021 12/10/2021 40.0 $1,626.00 $814.47
11/22/2021 11/28/2021 12/03/2021 23.9 $971.54 $351.15
11/15/2021 11/21/2021 11/26/2021 39.1 $1,589.42 $795.31
11/08/2021 11/14/2021 11/19/2021 40.0 $1,526.00 $794.57
11/01/2021 11/07/2021 11/12/2021 24.0 $2,986.00 $1,732.44
10/25/2021 10/31/2021 11/05/2021 32.0 $1,486.00 $685.07
10/18/2021 10/24/2021 10/29/2021 40.0 $1,486.00 $772.69
10/11/2021 10/17/2021 10/22/2021 40.0 $1,486.00 $772.69
10/04/2021 10/10/2021 10/15/2021 40.0 $1,486.00 $772.69
09/27/2021 10/03/2021 10/08/2021 40.0 $1,486.00 $772.69
09/20/2021 09/26/2021 10/01/2021 40.0 $1,486.00 $685.08
09/13/2021 09/19/2021 09/24/2021 32.0 $1,486.00 $772.68
09/06/2021 09/12/2021 09/17/2021 32.0 $1,486.00 $772.69
08/30/2021 09/05/2021 09/10/2021 40.0 $1,486.00 $772.69
08/23/2021 08/29/2021 09/03/2021 0.0 $1,486.00 $685.08
08/16/2021 08/22/2021 08/27/2021 0.0 $1,486.00 $772.68
08/09/2021 08/15/2021 08/20/2021 36.0 $1,486.00 $772.69
08/02/2021 08/08/2021 08/13/2021 40.0 $1,486.00 $772.68
07/26/2021 08/01/2021 08/06/2021 0.0 $1,486.00 $685.09
07/19/2021 07/25/2021 07/30/2021 16.0 $1,486.00 $772.69
07/12/2021 07/18/2021 07/23/2021 40.0 $1,486.00 $772.68
07/05/2021 07/11/2021 07/16/2021 32.0 $1,486.00 $772.70
06/28/2021 07/04/2021 07/09/2021 32.0 $1,486.00 $772.69
06/21/2021 06/27/2021 07/02/2021 40.0 $1,486.00 $685.93
EMPLOYER LEVEL DISCLAIMER

SSV: Please note YTD is inclusive for all of 2021. However, check detail is only available from July going forward due to a payroll
switch.? For historical data, please reference ER code 12899. Please use Headquarters Address above for
garnishment requests.
TSV: Please note YTD is inclusive for all of 2021. However, check detail is only available from July going forward due to a payroll
VOE: Please note YTD is inclusive for all of 2021. However, check detail is only available from July going forward due to a payroll
VOI: Please note YTD is inclusive for all of 2021. However, check detail is only available from July going forward due to a payroll

Hartford Healthcare 11574 389 John Downey Drive
New Britain , CT 06051
987229046394 Page 3 of 15
03/03/2022 Rafael A Ramirez 93001
Active 10/01/2012 9 years , 5 months Biomedical Technician II $33.45 Hourly
Original Hire Date Union Affiliation Work Location(Job site)

10/01/2012 ,
2022 $13,565.06 $91.99 $0.00 $0.00 $0.00 $13,657.05
2021 $68,781.32 $1,586.93 $0.00 $0.00 $0.00 $71,968.25
2020 $66,651.12 $1,356.58 $0.00 $0.00 $0.00 $69,207.70
2019 $64,649.24 $2,108.24 $0.00 $0.00 $0.00 $67,307.48
2018 $63,147.78 $835.77 $0.00 $0.00 $0.00 $64,333.55
2017 $56,525.34 $903.83 $650.00 $5,594.51 $63,673.68
2016 $54,795.25 $798.33 $500.00 $6,476.87 $62,070.45
2015 $53,299.97 $2,742.87 $6,479.09 $62,521.93
2014 $54,101.46 $1,342.96 $300.00 $6,480.65 $62,225.07
2013 $62,225.07
Next Projected Last


222672834 327 Cedar Street 8608691198 07/05/1969
Newington , Connecticut 06111
WORKERS' COMPENSATION
Claim Number Claim Pending
N

0.0 Bi-weekly

Income Withholding

Date Date
02/13/2022 02/26/2022 03/03/2022 82.0 $2,776.58 $1,730.81
01/30/2022 02/12/2022 02/17/2022 81.75 $2,764.03 $1,722.73
01/29/2022 02/03/2022 80.5 $2,701.29 $1,506.32
01/15/2022 01/20/2022 81.25 $2,738.93 $1,528.08
01/01/2022 01/06/2022 80.0 $2,676.22 $1,644.81
12/18/2021 12/23/2021 82.25 $2,789.11 $1,715.89
12/04/2021 12/09/2021 80.0 $2,676.21 $1,644.81
11/20/2021 11/24/2021 86.25 $3,610.84 $2,183.37
11/06/2021 11/10/2021 81.75 $2,751.48 $1,737.39
10/23/2021 10/28/2021 82.25 $3,707.88 $2,299.16
10/09/2021 10/14/2021 81.25 $2,659.16 $1,573.77
09/25/2021 09/30/2021 80.75 $2,769.19 $1,558.36
09/11/2021 09/16/2021 80.75 $2,634.80 $1,511.18
08/28/2021 09/02/2021 80.0 $2,598.26 $1,659.55
08/14/2021 08/19/2021 83.0 $2,744.42 $1,562.10
07/31/2021 08/05/2021 80.0 $2,598.26 $1,659.58
07/17/2021 07/22/2021 81.75 $2,683.52 $1,574.59
987229046394 Page 4 of 15
07/03/2021 07/08/2021 82.5 $2,720.06 $1,541.47
06/19/2021 06/24/2021 83.25 $2,756.60 $1,565.89
06/05/2021 06/10/2021 81.5 $2,671.35 $1,558.21
05/22/2021 05/27/2021 80.75 $2,634.80 $1,683.75
05/08/2021 05/13/2021 81.75 $2,683.52 $1,539.57
04/24/2021 04/29/2021 80.25 $2,610.44 $1,499.70
04/10/2021 04/15/2021 81.25 $2,659.16 $1,611.83
03/27/2021 04/01/2021 84.25 $2,826.27 $1,692.40
03/13/2021 03/18/2021 80.75 $2,634.80 $1,506.11
02/27/2021 03/04/2021 81.25 $2,659.16 $1,497.22
02/13/2021 02/18/2021 80.25 $2,614.50 $1,480.34
01/30/2021 02/04/2021 82.5 $2,927.31 $1,697.06
01/16/2021 01/21/2021 81.25 $2,724.52 $1,531.56
01/02/2021 01/07/2021 80.75 $2,622.63 $1,770.20
12/19/2020 12/24/2020 80.25 $2,614.51 $1,845.92
12/05/2020 12/10/2020 80.5 $2,622.62 $1,714.56
11/21/2020 11/25/2020 82.75 $3,332.24 $2,054.06
11/07/2020 11/12/2020 84.75 $2,850.63 $1,804.86
10/24/2020 10/29/2020 80.25 $2,553.01 $1,600.58
10/10/2020 10/15/2020 80.5 $2,564.92 $1,637.22
09/26/2020 10/01/2020 80.25 $2,553.01 $1,620.49
09/12/2020 09/17/2020 80.0 $2,541.09 $1,644.82
08/29/2020 09/03/2020 81.25 $2,600.65 $1,758.07
08/15/2020 08/20/2020 80.5 $2,564.91 $1,656.78
08/01/2020 08/06/2020 80.0 $2,541.10 $1,757.07
07/18/2020 07/23/2020 80.5 $2,564.92 $1,645.40
07/04/2020 07/09/2020 80.25 $2,553.01 $1,710.25
06/20/2020 06/25/2020 81.5 $2,612.56 $1,715.93
06/06/2020 06/11/2020 80.5 $2,564.92 $1,716.47
05/23/2020 05/28/2020 80.75 $2,776.50 $1,864.35
05/23/2020 05/14/2020 20.5 $659.10 $518.44
05/09/2020 05/14/2020 64.25 $2,640.82 $1,719.45
04/25/2020 04/30/2020 81.0 $2,588.74 $1,675.49
04/11/2020 04/16/2020 80.25 $2,549.04 $1,676.66
03/28/2020 04/02/2020 81.0 $2,588.74 $1,690.67
03/14/2020 03/19/2020 85.25 $2,791.24 $1,807.89
02/29/2020 03/05/2020 81.5 $2,612.56 $1,712.48
02/15/2020 02/20/2020 81.5 $2,612.56 $1,614.68
02/01/2020 02/06/2020 81.25 $2,600.65 $1,640.14
01/18/2020 01/23/2020 81.5 $2,612.56 $1,656.44
01/04/2020 01/09/2020 80.0 $2,541.09 $1,779.43
12/21/2019 12/26/2019 81.75 $2,624.47 $1,762.30
12/07/2019 12/12/2019 81.0 $2,572.86 $1,880.06
11/23/2019 11/27/2019 80.75 $3,126.83 $2,039.74
11/09/2019 11/14/2019 85.25 $2,791.24 $1,875.28
10/26/2019 10/31/2019 85.5 $2,721.49 $1,830.76
10/12/2019 10/17/2019 82.25 $2,571.16 $1,730.47
09/28/2019 10/03/2019 81.5 $2,536.46 $1,708.47
09/14/2019 09/19/2019 81.25 $2,524.90 $1,698.27
08/31/2019 09/05/2019 82.0 $2,559.60 $1,690.15
08/17/2019 08/22/2019 81.25 $2,524.90 $1,675.25
08/03/2019 08/08/2019 80.0 $2,467.08 $1,740.27
07/20/2019 07/25/2019 80.0 $2,467.08 $1,754.74
07/06/2019 07/11/2019 80.25 $2,474.79 $1,756.92
06/22/2019 06/27/2019 81.5 $2,528.76 $1,683.66
06/08/2019 06/13/2019 80.0 $2,474.79 $1,690.26
05/25/2019 05/30/2019 81.75 $2,548.03 $1,754.63
05/11/2019 05/16/2019 80.25 $2,478.64 $1,665.40
04/27/2019 05/02/2019 84.0 $2,652.11 $1,796.38
04/13/2019 04/18/2019 80.75 $2,501.77 $1,745.12
03/30/2019 04/04/2019 80.0 $2,467.08 $1,749.02
03/16/2019 03/21/2019 84.25 $2,671.38 $1,889.62
987229046394 Page 5 of 15
03/02/2019 03/07/2019 80.5 $2,490.20 $1,762.65
02/16/2019 02/21/2019 80.0 $2,467.08 $1,723.37
02/02/2019 02/07/2019 89.75 $3,103.64 $2,079.74
01/19/2019 01/24/2019 80.25 $2,478.64 $1,643.06
01/05/2019 01/10/2019 80.5 $2,482.50 $1,713.10
12/22/2018 12/27/2018 81.0 $2,515.50 $1,702.85
12/08/2018 12/13/2018 81.0 $2,513.34 $1,691.95
11/24/2018 11/29/2018 80.0 $2,467.08 $1,627.88
11/10/2018 11/15/2018 84.5 $2,675.24 $1,682.05
10/27/2018 11/01/2018 80.0 $2,418.70 $1,480.64
10/13/2018 10/18/2018 80.0 $2,418.70 $1,477.10
09/29/2018 10/04/2018 80.0 $2,418.70 $1,491.89
09/15/2018 09/20/2018 80.75 $2,441.38 $1,528.31
09/01/2018 09/06/2018 80.75 $2,452.72 $1,533.45
08/18/2018 08/23/2018 80.25 $2,430.04 $1,561.06
08/04/2018 08/09/2018 80.5 $2,441.38 $1,589.16
07/21/2018 07/26/2018 80.5 $2,441.38 $1,610.97
07/07/2018 07/12/2018 80.5 $2,437.60 $1,592.05
06/23/2018 06/28/2018 80.0 $2,422.48 $1,584.69
06/09/2018 06/14/2018 80.0 $2,418.71 $1,637.93
05/26/2018 05/31/2018 80.5 $2,441.38 $1,619.25
05/12/2018 05/17/2018 80.5 $2,441.38 $1,623.74
04/28/2018 05/03/2018 80.75 $2,452.72 $1,676.66
04/14/2018 04/19/2018 80.25 $2,426.26 $1,609.15
03/31/2018 04/05/2018 82.0 $2,498.07 $1,715.27
03/17/2018 03/22/2018 84.5 $2,619.00 $1,765.20
03/03/2018 03/08/2018 80.25 $2,426.26 $1,598.36
02/17/2018 02/22/2018 80.75 $2,452.72 $1,596.78
02/03/2018 02/08/2018 80.5 $2,441.38 $1,600.01
01/20/2018 01/25/2018 80.75 $2,452.72 $1,623.01
01/06/2018 01/11/2018 80.0 $2,418.71 $1,594.33
12/26/2017 12/26/2017 0.0 $0.00
12/25/2017 12/25/2017 0.0 $0.00
12/23/2017 12/28/2017 81.5 $2,494.65
12/16/2017 12/21/2017 0.0 $650.00
12/09/2017 12/14/2017 80.25 $2,430.04
11/25/2017 11/30/2017 80.5 $2,433.82
11/11/2017 11/16/2017 84.0 $2,600.11
10/28/2017 11/02/2017 80.25 $2,388.24
10/14/2017 10/19/2017 80.0 $2,377.10
09/30/2017 10/05/2017 85.5 $2,622.24
09/16/2017 09/21/2017 80.25 $2,384.53
09/02/2017 09/07/2017 80.25 $2,388.24
08/19/2017 08/24/2017 80.5 $2,399.39
08/05/2017 08/10/2017 80.0 $2,377.10
07/22/2017 07/27/2017 81.0 $2,421.67
07/08/2017 07/13/2017 81.25 $2,421.68
06/24/2017 06/29/2017 81.0 $2,421.68
06/10/2017 06/15/2017 81.25 $2,432.81
05/27/2017 06/01/2017 80.0 $2,377.10
05/13/2017 05/18/2017 80.25 $2,388.24
04/29/2017 05/04/2017 80.0 $2,377.10
04/15/2017 04/20/2017 80.25 $2,388.24
04/01/2017 04/06/2017 80.25 $2,388.24
03/18/2017 03/23/2017 80.0 $2,380.82
03/04/2017 03/09/2017 80.75 $2,410.53
02/18/2017 02/23/2017 81.0 $2,421.67
02/04/2017 02/09/2017 80.25 $2,388.24
01/21/2017 01/26/2017 81.0 $2,421.67
01/07/2017 01/12/2017 83.75 $2,488.53
12/29/2016 12/29/2016 0.0 $0.00
12/28/2016 12/28/2016 0.0 $0.00
987229046394 Page 6 of 15
12/28/2016 12/24/2016 0.0 $0.00
12/27/2016 12/30/2016 0.0 $0.00
12/27/2016 12/27/2016 0.0 $0.00
12/24/2016 12/29/2016 80.25 $2,388.24
12/17/2016 12/22/2016 0.0 $500.00
12/10/2016 12/15/2016 81.5 $2,443.96
11/26/2016 12/01/2016 80.0 $2,377.11
11/12/2016 11/17/2016 85.0 $2,627.73
10/29/2016 11/03/2016 80.75 $2,363.27
10/15/2016 10/20/2016 80.0 $2,330.50
10/01/2016 10/06/2016 80.0 $2,330.50
09/17/2016 09/22/2016 80.0 $2,330.50
09/03/2016 09/08/2016 80.0 $2,330.50
08/20/2016 08/25/2016 80.0 $2,345.07
08/06/2016 08/11/2016 80.0 $2,330.50

SSV: The personnel data provided by this automated service is derived entirely from Hartford HealthCare employee management
systems. For any questions related to the start date provided by the employee and what the Work Number is reporting you may
contact the local HR Department. Please note that The Charlotte Hungerford Hospital employees merged with
Hartford Healthcare. If the employee worked for Charlotte Hungerford prior to 10/1/2019, employee historical wages can be
found under employer code 17644. Please note that St. Vincent's Medical Center and St. Vincent's Special Needs
Center have been acquired by Hartford Healthcare.?If the employee worked for?St. Vincent's Medical Center or St. Vincent's
Special Needs Center?prior to 12/15/2019, employee historical wages can be found under employer code 14257.
VOE: The personnel data provided by this automated service is derived entirely from Hartford HealthCare employee management
VOI: The personnel data provided by this automated service is derived entirely from Hartford HealthCare employee management

Triumph Group Operations-Historical Data Only 12899 899 Cassatt RoadSuite 210
Berwyn , PA 19312

06/25/2021 RAFAEL A RAMIREZ
Transferred 01/28/1998 23 years , 7 months HOURLY IV TECHNICIAN $35.05 Hourly
Date of Termination Original Hire Date Union Affiliation Work Location(Job site)
08/09/2021 01/28/1998 ,
2021 $36,732.49 $0.00 $0.00 $3,079.03 $0.00 $39,811.52
2020 $76,167.72 $1,032.48 $0.00 $2,130.34 $0.00 $79,330.54
2019 $72,703.63 $831.36 $0.00 $3,043.96 $0.00 $76,578.95
2018 $70,514.05 $218.23 $0.00 $3,106.66 $0.00 $73,838.94
2017 $69,060.95 $424.25 $0.00 $2,258.35 $0.00 $71,743.55
2016 $65,377.94 $765.60 $0.00 $2,851.82 $0.00 $68,995.36
2015 $62,298.90 $1,246.87 $0.00 $2,280.22 $0.00 $65,825.99
2014 $61,010.86 $758.10 $0.00 $2,356.95 $0.00 $64,125.91
2013 $45,676.24 $11,089.42 $0.00 $0.00 $0.00 $56,765.66
987229046394 Page 7 of 15
Next Projected Last

510347964 327 CEDAR STREET 07/05/1969
NEWINGTON 06111
MEDICAL INSURANCE
Insurance Available Employee Eligible Employee Enrolled
N N N
Carrier Name Carrier Address Carrier Phone Number Policy Number
,
Annual Cost Dependent Coverage Available
0 N
Name SSN Birth Date
Participating in COBRA
N
DENTAL INSURANCE
Insurance Available Employee Eligible Employee Enrolled Carrier Name Carrier Phone Number Policy Number
N N N
VISION INSURANCE
N N N

0.0 Weekly

Income Withholding

Date Date
06/20/2021 06/25/2021 40.0 $1,486.00 $832.73
06/13/2021 06/18/2021 40.0 $1,486.00 $831.88
06/06/2021 06/11/2021 39.4 $1,463.71 $819.21
05/30/2021 06/04/2021 40.0 $1,486.00 $745.11
05/23/2021 05/28/2021 40.0 $1,486.00 $832.80
05/16/2021 05/21/2021 40.0 $1,486.00 $832.73
05/09/2021 05/14/2021 40.0 $4,565.03 $2,526.87
05/02/2021 05/07/2021 40.0 $1,486.00 $745.10
04/25/2021 04/30/2021 40.0 $1,486.00 $832.72
04/18/2021 04/23/2021 40.0 $1,486.00 $832.75
04/11/2021 04/16/2021 40.0 $1,486.00 $844.60
04/04/2021 04/09/2021 40.0 $1,486.00 $844.61
03/28/2021 04/02/2021 40.0 $1,486.00 $756.91
03/21/2021 03/26/2021 40.0 $1,486.00 $844.54
03/14/2021 03/19/2021 40.0 $1,486.00 $844.53
03/07/2021 03/12/2021 40.0 $1,486.00 $844.54
02/28/2021 03/05/2021 37.2 $1,381.98 $689.78
02/14/2021 02/19/2021 40.0 $1,449.60 $821.16
987229046394 Page 8 of 15
02/07/2021 02/12/2021 40.0 $1,449.60 $833.12
01/31/2021 02/05/2021 40.0 $1,449.60 $771.30
01/24/2021 01/29/2021 40.0 $1,449.60 $856.65
01/17/2021 01/22/2021 40.0 $1,449.60 $856.67
01/10/2021 01/15/2021 40.0 $1,449.60 $856.65
01/03/2021 01/08/2021 40.0 $1,449.60 $863.53
12/27/2020 12/31/2020 40.0 $1,449.60 $973.25
12/20/2020 12/24/2020 32.0 $1,159.68 $760.35
12/13/2020 12/18/2020 40.0 $1,449.60 $955.90
12/06/2020 12/11/2020 40.0 $1,449.60 $955.91
11/29/2020 12/04/2020 40.0 $1,449.60 $870.56
11/22/2020 11/27/2020 40.0 $1,449.60 $955.91
11/15/2020 11/20/2020 39.5 $1,431.48 $943.54
11/08/2020 11/13/2020 40.0 $1,449.60 $955.90
11/01/2020 11/06/2020 40.0 $1,449.60 $870.56
10/25/2020 10/30/2020 40.0 $1,449.60 $955.92
10/18/2020 10/23/2020 40.0 $1,449.60 $955.91
10/11/2020 10/16/2020 40.0 $1,449.60 $955.91
10/04/2020 10/09/2020 40.0 $1,449.60 $955.91
09/27/2020 10/02/2020 39.6 $1,435.10 $860.66
09/20/2020 09/25/2020 40.0 $1,449.60 $955.91
09/13/2020 09/18/2020 40.0 $1,449.60 $955.91
09/06/2020 09/11/2020 40.0 $1,449.60 $955.91
08/30/2020 09/04/2020 40.0 $1,449.60 $870.55
08/23/2020 08/28/2020 40.0 $1,449.60 $955.91
08/16/2020 08/21/2020 40.0 $1,449.60 $955.91
08/09/2020 08/14/2020 40.0 $1,449.60 $955.91
08/02/2020 08/07/2020 40.0 $1,449.60 $870.56
07/26/2020 07/31/2020 40.0 $1,449.60 $955.91
07/19/2020 07/24/2020 40.0 $1,449.60 $955.91
07/12/2020 07/17/2020 40.0 $1,449.60 $955.91
07/05/2020 07/10/2020 40.0 $1,449.60 $955.92
06/28/2020 07/03/2020 40.0 $1,449.60 $870.56
06/21/2020 06/26/2020 40.0 $1,449.60 $955.91
06/14/2020 06/19/2020 40.0 $1,449.60 $955.91
06/07/2020 06/12/2020 40.0 $1,449.60 $955.90
05/31/2020 06/05/2020 40.0 $1,449.60 $870.56
05/24/2020 05/29/2020 40.0 $1,449.60 $955.91
05/17/2020 05/22/2020 40.0 $3,579.94 $2,336.86
05/10/2020 05/15/2020 40.0 $1,449.60 $955.91
05/03/2020 05/08/2020 40.0 $1,449.60 $955.91
04/26/2020 05/01/2020 40.0 $1,449.60 $870.56
04/19/2020 04/24/2020 40.0 $1,449.60 $955.91
04/12/2020 04/17/2020 40.0 $1,449.60 $955.91
04/05/2020 04/10/2020 40.0 $1,449.60 $955.91
03/29/2020 04/03/2020 40.0 $1,449.60 $870.56
03/22/2020 03/27/2020 40.0 $1,449.60 $955.90
03/15/2020 03/20/2020 48.0 $1,739.52 $1,153.02
03/08/2020 03/13/2020 40.0 $1,449.60 $955.91
03/01/2020 03/06/2020 39.4 $1,427.86 $856.10
02/23/2020 02/28/2020 52.0 $1,732.64 $1,148.31
02/16/2020 02/21/2020 52.0 $1,838.72 $1,160.02
02/09/2020 02/14/2020 40.0 $1,414.40 $817.94
02/02/2020 02/07/2020 40.0 $1,414.40 $802.82
01/26/2020 01/31/2020 40.0 $1,414.40 $885.98
01/19/2020 01/24/2020 40.0 $1,414.40 $885.98
01/12/2020 01/17/2020 40.0 $1,414.40 $885.97
01/05/2020 01/10/2020 40.0 $1,414.40 $912.26
12/29/2019 01/03/2020 40.0 $1,414.40 $829.11
12/22/2019 12/27/2019 40.0 $1,414.40 $910.95
12/15/2019 12/20/2019 40.0 $1,414.40 $910.93
12/08/2019 12/13/2019 40.0 $1,414.40 $910.95
987229046394 Page 9 of 15
12/01/2019 12/06/2019 40.0 $1,414.40 $827.78
11/24/2019 11/29/2019 38.0 $1,343.68 $863.06
11/17/2019 11/22/2019 40.0 $1,414.40 $910.94
11/10/2019 11/15/2019 40.0 $1,414.40 $910.94
11/03/2019 11/08/2019 40.0 $1,414.40 $910.94
10/27/2019 11/01/2019 40.0 $1,414.40 $827.79
10/20/2019 10/25/2019 40.0 $1,414.40 $910.95
10/13/2019 10/18/2019 40.0 $1,414.40 $910.93
10/06/2019 10/11/2019 40.0 $1,414.40 $910.95
09/29/2019 10/04/2019 40.0 $1,414.40 $827.79
09/22/2019 09/27/2019 40.0 $1,414.40 $910.94
09/15/2019 09/20/2019 40.0 $1,414.40 $910.95
09/08/2019 09/13/2019 40.0 $1,414.40 $841.81
09/01/2019 09/06/2019 40.0 $1,414.40 $827.80
08/25/2019 08/30/2019 40.0 $1,414.40 $910.94
08/18/2019 08/23/2019 40.0 $1,414.40 $910.94
08/11/2019 08/16/2019 40.0 $1,414.40 $910.94
08/04/2019 08/09/2019 40.0 $1,414.40 $910.94
07/28/2019 08/02/2019 40.0 $1,414.40 $827.79
07/21/2019 07/26/2019 40.0 $1,414.40 $910.95
07/14/2019 07/19/2019 36.0 $1,272.96 $815.54
07/07/2019 07/12/2019 40.0 $1,414.40 $910.95
06/30/2019 07/05/2019 40.0 $1,414.40 $827.78
06/23/2019 06/28/2019 39.8 $1,407.33 $906.12
06/16/2019 06/21/2019 40.0 $1,414.40 $910.93
06/09/2019 06/14/2019 40.0 $1,414.40 $910.95
06/02/2019 06/07/2019 40.0 $1,414.40 $827.79
05/26/2019 05/31/2019 40.0 $1,414.40 $910.94
05/19/2019 05/24/2019 40.0 $1,414.40 $910.94
05/12/2019 05/17/2019 40.0 $4,458.36 $2,867.55
05/05/2019 05/10/2019 40.0 $1,414.40 $910.95
04/28/2019 05/03/2019 36.5 $1,290.64 $744.08
04/21/2019 04/26/2019 39.0 $1,379.04 $886.80
04/14/2019 04/19/2019 36.0 $1,272.96 $815.56
04/07/2019 04/12/2019 40.0 $1,414.40 $910.94
03/31/2019 04/05/2019 40.0 $1,414.40 $827.79
03/24/2019 03/29/2019 40.0 $1,414.40 $910.95
03/17/2019 03/22/2019 40.0 $1,414.40 $910.93
03/10/2019 03/15/2019 40.0 $1,414.40 $910.95
03/03/2019 03/08/2019 39.5 $1,396.72 $898.86
02/24/2019 03/01/2019 40.0 $1,385.60 $809.93
02/17/2019 02/22/2019 40.0 $1,385.60 $891.29
02/10/2019 02/15/2019 40.0 $1,385.60 $892.24
02/03/2019 02/08/2019 39.6 $1,371.74 $882.04
01/27/2019 02/01/2019 39.0 $1,350.96 $786.50
01/20/2019 01/25/2019 40.0 $1,385.60 $891.14
01/13/2019 01/18/2019 40.0 $1,385.60 $891.12
01/06/2019 01/11/2019 40.0 $1,385.60 $891.12
12/30/2018 01/04/2019 64.0 $2,216.96 $1,347.40
12/23/2018 12/28/2018 40.0 $1,385.60 $854.20
12/16/2018 12/21/2018 40.0 $1,385.60 $809.25
12/09/2018 12/14/2018 40.0 $1,385.60 $809.25
12/02/2018 12/07/2018 40.0 $1,385.60 $727.90
11/25/2018 11/30/2018 40.0 $1,385.60 $809.25
11/18/2018 11/23/2018 40.0 $1,385.60 $809.26
11/11/2018 11/16/2018 40.0 $1,385.60 $809.25
11/04/2018 11/09/2018 40.0 $1,385.60 $809.25
10/28/2018 11/02/2018 38.1 $1,319.78 $685.53
10/21/2018 10/26/2018 40.0 $1,385.60 $809.26
10/14/2018 10/19/2018 40.0 $1,385.60 $809.25
10/07/2018 10/12/2018 40.0 $1,385.60 $809.26
09/30/2018 10/05/2018 36.6 $1,267.82 $652.17
987229046394 Page 10 of 15
09/23/2018 09/28/2018 40.0 $1,385.60 $809.25
09/16/2018 09/21/2018 40.0 $1,385.60 $809.25
09/09/2018 09/14/2018 40.0 $1,385.60 $809.25
09/02/2018 09/07/2018 40.0 $1,385.60 $727.90
08/26/2018 08/31/2018 40.0 $1,385.60 $809.26
08/19/2018 08/24/2018 40.0 $1,385.60 $809.25
08/12/2018 08/17/2018 40.0 $1,385.60 $809.25
08/05/2018 08/10/2018 40.0 $1,385.60 $809.25
07/29/2018 08/03/2018 38.3 $1,326.71 $690.05
07/22/2018 07/27/2018 40.0 $1,385.60 $843.16
07/15/2018 07/20/2018 37.9 $1,312.86 $794.49
07/08/2018 07/13/2018 40.0 $1,385.60 $843.16
07/01/2018 07/06/2018 40.0 $1,385.60 $761.82
06/24/2018 06/29/2018 40.0 $1,385.60 $843.16

SSV: This employer has moved to Employer Code 3853986 effective 07/01/2021. All information for transferred employees can be
found under the new Employer Code 3853986 after their transfer date. Garnishment requests should be sent to
Triumph Group Inc, Attn Payroll, 205 Church Rd, North Wales, PA 19454. This is a general employer message and is provided
on every verification for your information and convenience.
VOE: This employer has moved to Employer Code 3853986 effective 07/01/2021. All information for transferred employees can be
VOI: This employer has moved to Employer Code 3853986 effective 07/01/2021. All information for transferred employees can be

UTC Aerospace Systems Inactives and Transfers Only 11303 One Hamilton Road
Windsor Locks , CT 06096

12/31/2013 RAFAEL A RAMIREZ
Inactive 07/26/2012 0 years , 8 months ASSEMBLER/TESTER-W H $28.77 Hourly
Date of Termination Original Hire Date Union Affiliation Work Location(Job site)
03/17/2013 01/28/1998 ,
2013 $11,220.99 $6,647.18 $0.00 $3,381.09 $2,261.60 $23,510.86
2012 $57,277.89 $21,739.51 $0.00 $1,525.32 $2,000.00 $82,542.72
2011 $58,685.97 $14,223.13 $0.00 $1,000.00 $2,036.06 $75,945.16
2010 $57,517.68 $9,229.64 $45.00 $66,792.32
2009 $54,802.31 $11,047.44 $651.36 $66,501.11
2008 $54,031.02 $21,060.86 $211.44 $75,303.32
2007 $53,019.29 $14,949.81 $67,969.10
2006 $49,513.77 $8,900.36 $1,000.00 $817.68 $60,231.81
Next Projected Last


562276020 168 CEDAR STREET 8606671191 07/05/1969
NEWINGTON 06111
MEDICAL INSURANCE
987229046394 Page 11 of 15
Insurance Available Employee Eligible Employee Enrolled
N N N
Carrier Name Carrier Address Carrier Phone Number Policy Number
,
Annual Cost Dependent Coverage Available
0 N
Name SSN Birth Date
Participating in COBRA
N
DENTAL INSURANCE
N N N
VISION INSURANCE
N N N

0.0 Weekly

Income Withholding

Date Date
03/17/2013 03/21/2013 70.4 $2,344.01 $0.00
03/10/2013 03/14/2013 67.8 $1,828.68 $0.00
03/03/2013 03/07/2013 61.4 $1,627.99 $0.00
02/24/2013 02/28/2013 58.0 $1,599.97 $0.00
02/17/2013 02/21/2013 58.9 $1,583.94 $0.00
02/10/2013 02/14/2013 45.9 $1,246.82 $0.00
02/03/2013 02/07/2013 60.0 $4,509.36 $0.00
01/27/2013 01/31/2013 57.4 $1,585.35 $0.00
01/20/2013 01/24/2013 55.0 $1,459.66 $0.00
01/13/2013 01/17/2013 56.0 $1,481.58 $0.00
01/06/2013 01/10/2013 63.8 $1,709.59 $0.00
12/30/2012 01/03/2013 88.0 $2,533.91 $0.00
12/23/2012 12/27/2012 67.4 $1,790.29
12/16/2012 12/20/2012 67.8 $1,812.23
12/09/2012 12/13/2012 60.0 $1,642.60
12/02/2012 12/06/2012 64.5 $1,687.84
11/25/2012 11/29/2012 67.8 $1,914.60
11/18/2012 11/21/2012 67.8 $1,813.69
11/11/2012 11/15/2012 40.0 $1,102.55
11/04/2012 11/08/2012 41.5 $1,097.19
10/28/2012 11/01/2012 51.0 $1,412.54
10/21/2012 10/25/2012 58.2 $1,604.58
10/14/2012 10/18/2012 50.2 $1,341.86
10/07/2012 10/11/2012 58.4 $1,534.39
09/30/2012 10/04/2012 66.0 $1,759.59
09/23/2012 09/27/2012 55.6 $1,528.93
09/16/2012 09/20/2012 58.0 $2,122.79
09/09/2012 09/13/2012 48.4 $1,618.29
987229046394 Page 12 of 15
09/02/2012 09/07/2012 41.9 $1,141.05
08/26/2012 08/30/2012 62.0 $1,585.96
08/19/2012 08/23/2012 66.6 $1,744.55
07/29/2012 08/02/2012 73.0 $1,894.74
07/22/2012 07/26/2012 155.2 $4,165.59
07/15/2012 07/19/2012 67.0 $1,745.96
07/08/2012 07/12/2012 54.7 $1,430.17
07/01/2012 07/05/2012 66.2 $1,674.38
06/24/2012 06/28/2012 63.4 $1,674.37
06/17/2012 06/21/2012 73.4 $1,891.91
06/10/2012 06/14/2012 43.0 $1,178.94
06/03/2012 06/07/2012 47.8 $1,287.01
05/27/2012 06/01/2012 64.0 $1,684.20
05/20/2012 05/24/2012 48.0 $1,291.22
05/13/2012 05/17/2012 50.0 $1,333.33
05/06/2012 05/10/2012 57.0 $1,480.70
04/29/2012 05/03/2012 66.0 $1,726.31
04/22/2012 04/26/2012 56.0 $1,459.64
04/15/2012 04/19/2012 48.7 $3,302.45
04/08/2012 04/12/2012 40.0 $1,122.80
04/01/2012 04/05/2012 51.0 $1,354.38
03/25/2012 03/29/2012 58.0 $1,571.92
03/18/2012 03/22/2012 40.0 $2,648.12
03/11/2012 03/15/2012 40.0 $1,122.80
03/04/2012 03/08/2012 50.1 $1,406.31
02/26/2012 03/01/2012 59.9 $1,622.45
02/19/2012 02/23/2012 58.8 $1,592.97
02/12/2012 02/16/2012 49.0 $1,312.28
02/05/2012 02/09/2012 61.6 $1,658.95
01/29/2012 02/02/2012 57.2 $1,541.05
01/22/2012 01/26/2012 47.0 $1,242.10
01/15/2012 01/19/2012 48.0 $1,277.19
01/08/2012 01/12/2012 36.6 $1,027.36
01/01/2012 01/05/2012 91.4 $2,565.60
12/25/2011 12/29/2011 61.2 $1,675.79
12/18/2011 12/22/2011 64.4 $1,694.02
12/11/2011 12/15/2011 51.8 $1,371.22
12/04/2011 12/08/2011 46.0 $1,285.18
11/27/2011 12/01/2011 65.0 $1,810.52
11/20/2011 11/23/2011 63.4 $1,672.98
11/13/2011 11/17/2011 46.4 $1,257.53
11/06/2011 11/10/2011 92.6 $2,510.86
10/30/2011 11/03/2011 52.0 $1,375.43
10/23/2011 10/27/2011 56.0 $1,459.64
10/16/2011 10/20/2011 60.2 $1,604.20
10/09/2011 10/13/2011 62.0 $1,642.10
10/02/2011 10/06/2011 44.0 $1,207.01
09/25/2011 09/29/2011 62.6 $1,672.97
09/18/2011 09/22/2011 63.5 $1,684.21
09/11/2011 09/15/2011 54.0 $1,417.54
09/04/2011 09/09/2011 66.4 $1,678.58
08/28/2011 09/01/2011 64.0 $1,628.06
08/21/2011 08/25/2011 64.2 $1,632.27
08/14/2011 08/18/2011 42.0 $1,164.91
08/07/2011 08/11/2011 63.9 $1,625.25
07/31/2011 08/04/2011 14.0 $392.98
07/24/2011 07/28/2011 70.5 $1,861.04
07/17/2011 07/21/2011 104.8 $2,837.88
07/10/2011 07/14/2011 63.4 $1,615.43
07/03/2011 07/08/2011 51.9 $1,358.59
06/26/2011 06/30/2011 59.4 $1,604.20
06/19/2011 06/23/2011 47.1 $1,264.55
987229046394 Page 13 of 15
06/12/2011 06/16/2011 49.5 $1,319.30
06/05/2011 06/09/2011 54.0 $1,515.78
05/29/2011 06/03/2011 59.4 $1,597.19
05/22/2011 05/26/2011 40.0 $1,122.80
05/15/2011 05/19/2011 40.0 $1,122.80
05/08/2011 05/12/2011 40.0 $1,122.80
05/01/2011 05/05/2011 40.0 $1,122.80
04/24/2011 04/28/2011 40.0 $1,122.80
04/17/2011 04/21/2011 38.7 $1,086.31
04/10/2011 04/14/2011 38.0 $3,066.66
04/03/2011 04/07/2011 39.0 $1,094.73
03/27/2011 03/31/2011 39.0 $2,094.73
03/20/2011 03/24/2011 55.4 $1,496.13
03/13/2011 03/17/2011 58.5 $1,584.56
03/06/2011 03/10/2011 39.5 $1,108.77
02/27/2011 03/03/2011 39.4 $1,105.96
02/20/2011 02/24/2011 51.4 $1,442.80
02/13/2011 02/17/2011 39.5 $1,108.77
02/06/2011 02/10/2011 39.5 $1,108.77
01/30/2011 02/03/2011 39.0 $1,094.73
01/23/2011 01/27/2011 41.6 $1,160.70
01/16/2011 01/20/2011 39.0 $1,094.73
01/09/2011 01/13/2011 40.0 $1,122.80
01/02/2011 01/06/2011 40.0 $1,122.80
12/26/2010 12/30/2010 40.0 $1,122.80
12/19/2010 12/23/2010 40.0 $1,122.80
12/12/2010 12/16/2010 39.5 $1,131.27
12/05/2010 12/09/2010 40.6 $1,135.43
11/28/2010 12/02/2010 39.0 $1,094.73
11/21/2010 11/24/2010 39.9 $1,119.99
11/14/2010 11/18/2010 38.8 $1,089.12
11/07/2010 11/11/2010 40.0 $1,122.80
10/31/2010 11/04/2010 40.0 $1,122.80
10/24/2010 10/28/2010 40.0 $1,122.80
10/17/2010 10/21/2010 39.8 $1,139.69
10/10/2010 10/14/2010 39.8 $1,117.19
10/03/2010 10/07/2010 38.6 $1,083.50
09/26/2010 09/30/2010 39.7 $1,114.38
09/19/2010 09/23/2010 39.4 $1,105.96
09/12/2010 09/16/2010 37.3 $1,047.01
09/05/2010 09/10/2010 38.4 $1,077.89
08/29/2010 09/02/2010 59.3 $1,616.94
08/22/2010 08/26/2010 48.6 $1,294.56
08/15/2010 08/19/2010 55.2 $1,432.52
08/08/2010 08/12/2010 59.2 $1,516.13
08/01/2010 08/05/2010 69.2 $1,725.15
07/25/2010 07/29/2010 20.4 $501.66
07/18/2010 07/22/2010 48.7 $1,288.98
07/11/2010 07/15/2010 79.7 $2,221.24
07/04/2010 07/09/2010 40.0 $1,114.80
06/27/2010 07/01/2010 61.9 $1,647.12
06/20/2010 06/24/2010 48.4 $1,266.69
06/13/2010 06/17/2010 40.3 $1,120.37
06/06/2010 06/10/2010 39.6 $1,103.65
05/30/2010 06/04/2010 40.9 $1,132.92
05/23/2010 05/27/2010 39.9 $1,112.01
05/16/2010 05/20/2010 38.9 $1,081.36
05/09/2010 05/13/2010 40.0 $1,114.80
05/02/2010 05/06/2010 39.7 $1,106.44
04/25/2010 04/29/2010 50.6 $1,336.37
04/18/2010 04/22/2010 63.2 $1,677.77
04/11/2010 04/15/2010 39.2 $1,092.50
987229046394 Page 14 of 15
04/04/2010 04/08/2010 41.8 $1,152.42
03/28/2010 04/01/2010 40.0 $1,114.80
03/21/2010 03/25/2010 64.5 $1,714.02
03/14/2010 03/18/2010 63.6 $1,670.82

SSV: Employees with a Transferred status as of?July 10, 2021?under?UTC Aerospace Systems?may have more recent information
loading to Raytheon Technologies Corporation employer code 13770 on The Work Number service, as part of an employer
code consolidation. Please send wage garnishment requests to: UTC SBS Payroll, 9 Farm Springs Rd, Mail Stop
541-48, Farmington CT 06032 Please note that Total Time With Employer is calculated from the Most Recent Start
Date. The Original Hire Date can differ from the Most Recent Start Date when either a) the employee experienced a break-in-
service or b) where there was an acquisition. In the event of a break-in-service the Most Recent Start Date will reflect the date
when the employee was re-hired by the company. In the event of an acquisition the Most Recent Start Date will reflect the date
when the transaction was closed. Please note that in these two situations the Total Time With Employer may not reflect the
methodology that we use to calculate an employee's length of service. In such cases, the Total Time with Employer can usually
be manually calculated by using the Original Hire Date rather than the Most Recent Start Date. UTC changed the
titling structure for U.S. employees in June 2017 (excluding executives and production / factory employees).
VOE: Employees with a Transferred status as of July 10, 2021 under UTC Aerospace Systems may have more recent information
VOI: Employees with a Transferred status as of July 10, 2021 under UTC Aerospace Systems may have more recent information
987229046394 Page 15 of 15
State of Connecticut – Notice to Connecticut Consumers
Note: The terms "consumer report", "credit report" and "credit file" as may be used in this notice are
intended to reference your Employment Data Report issued by TALX Corporation, a provider of The
Work Number®. The term "consumer reporting agency" or similar terms in this notice refer to TALX
Corporation, a provider of The Work Number. Please note that The Work Number does not provide
traditional credit information, but state law may include the employment and income data provided
by The Work Number within its definition of a consumer report.
You have the right to obtain a copy of your credit file from a credit reporting agency. You
may be charged a reasonable fee not exceeding $5.00 for your first request in 12 months
or $7.50 for any subsequent request in that same 12 month period. There is no fee,
however, if you have been turned down for credit, employment, insurance, or a rental
dwelling because of information in your credit report within the preceding 60 days. The
credit reporting agency must provide someone to help you interpret the information in your
credit file.
You have the right to dispute inaccurate information by contacting the credit reporting
agency directly. However, neither you nor any credit repair company or credit service
organization has the right to have accurate, current, and verifiable information removed
from your credit report.
Under the Federal Fair Credit Reporting Act, the credit reporting agency must remove
accurate, negative information from your report only if it is over seven years old.
Bankruptcy information can be reported for 10 years.
If you have notified a credit reporting agency in writing that you dispute the accuracy of
information in your file, the credit reporting agency must then, within 30 business days,
reinvestigate and modify or remove inaccurate information. If you provide additional
information to the credit reporting agency, the agency may extend this time period by 15
business days. The credit reporting agency shall provide you with a toll-free telephone
number to use in resolving the dispute.
The credit reporting agency may not charge a fee for this service. Any pertinent
information and copies of all documents you have concerning an error should be given to
the credit reporting agency.
If the reinvestigation does not resolve the dispute to your satisfaction, you may send a
brief statement to the credit reporting agency to keep in your file, explaining why you think
the record is inaccurate. The credit reporting agency must include your statement about
disputed information in a report it issues about you.
You have the right to receive a record of all inquiries relating to a credit transaction
initiated in 12 months preceding your request which resulted in the provision of a credit
report.
You may request in writing that the information contained in your file not be provided to a third party
for marketing purposes.
If you have reviewed your credit report with the credit reporting agency and are
dissatisfied, you may contact the Connecticut Department of Banking. You have a right to
bring civil action against anyone who knowingly or willfully misuses file data or improperly
obtains access to your file.
Right to Place a Security Freeze
You have a right to place a security freeze on your data report which will prohibit a credit
reporting agency from releasing any information in your data report without your express
authorization. A security freeze may be requested in writing by mail or by electronic means
as described below. The security freeze is designed to prevent a credit reporting agency
from releasing your data report without your consent. However, you should be aware that
using a security freeze to take control over who is allowed access to the personal and
financial information in your data report may delay, interfere with or prohibit the timely
approval of any subsequent request or application you make regarding a new loan, credit,
mortgage, insurance, rental housing, employment, investment, license, cellular telephone,
utilities, or other services, including an extension of credit at point of sale. When you place
a security freeze on your data report, you will be provided a personal identification number
or password to use if you choose to remove the security freeze from your data report or to
authorize the temporary release of your data report for a specific party or period of time
after the security freeze is in place. To provide that authorization, you must contact the
credit reporting agency and provide all the following:
1. Proper identification.
2. The unique personal identification number or password provided by the credit reporting agency.
3. The proper information regarding the specific party who is to receive the data report or the
specific period of time for which the data report is to be available.
TALX Corporation will authorize the release of your data report no later than fifteen (15)
minutes after receiving the above information if the request is by electronic means or no
later than three business days when a written request is submitted.
TALX Corporation will permanently remove the security freeze from your data report not
later than 3 business days after receiving your request to do so.
How to Freeze Your Report
A security freeze request may be sent via mail to:
Equifax Workforce Solutions

Attn: Employment Data Freeze
3470 Rider Trail South
Earth City, MO 63045
You may also send a freeze request to:

Email: [email protected]
Phone: 1-866-222-5880
Fax: 877-879-8182
We will provide you with confirmation of the placement of your freeze. Please note that although
some state laws may allow us to charge a fee, TALX Corporation never charges any fees to place or
remove a security freeze.
Para información en español, visite www.consumerfinance.gov/learnmore o escribe a la
Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and
privacy of information in the files of consumer reporting agencies. There are many types of
consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies
that sell information about check writing histories, medical records, and rental history records).
Here is a summary of your major rights under FCRA. For more information, including
information about additional rights, go to www.consumerfinance.gov/learnmore or write
to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
● You must be told if information in your file has been used against you. Anyone who
uses a credit report or another type of consumer report to deny your application for credit,
insurance, or employment – or to take another adverse action against you – must tell you,
and must give you the name, address, and phone number of the agency that provided the
information.
● You have the right to know what is in your file. You may request and obtain all the
information about you in the files of a consumer reporting agency (your “file
disclosure”). You will be required to provide proper identification, which may include
your Social Security number. In many cases, the disclosure will be free. You are entitled
to a free file disclosure if:
o a person has taken adverse action against you because of information in your
credit report;
o you are the victim of identity theft and place a fraud alert in your file;
o your file contains inaccurate information as a result of fraud;
o you are on public assistance;
o you are unemployed but expect to apply for employment within 60 days.
In addition, all consumers are entitled to one free disclosure every 12 months upon
request from each nationwide credit bureau and from nationwide specialty consumer
reporting agencies. See www.consumerfinance.gov/learnmore for additional
information.
● You have the right to ask for a credit score. Credit scores are numerical summaries of
your credit-worthiness based on information from credit bureaus. You may request a
credit score from consumer reporting agencies that create scores or distribute scores used
in residential real property loans, but you will have to pay for it. In some mortgage
transactions, you will receive credit score information for free from the mortgage lender.
● You have the right to dispute incomplete or inaccurate information. If you identify
information in your file that is incomplete or inaccurate, and report it to the consumer
reporting agency, the agency must investigate unless your dispute is frivolous. See
www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
● Consumer reporting agencies must correct or delete inaccurate, incomplete, or

unverifiable information. Inaccurate, incomplete, or unverifiable information must be
1
removed or corrected, usually within 30 days. However, a consumer reporting agency
may continue to report information it has verified as accurate.
● Consumer reporting agencies may not report outdated negative information. In

most cases, a consumer reporting agency may not report negative information that is
more than seven years old, or bankruptcies that are more than 10 years old.
● Access to your file is limited. A consumer reporting agency may provide information
about you only to people with a valid need – usually to consider an application with a
creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a
valid need for access.
● You must give your consent for reports to be provided to employers. A consumer
reporting agency may not give out information about you to your employer, or a potential
employer, without your written consent given to the employer. Written consent generally
is not required in the trucking industry. For more information, go to
www.consumerfinance.gov/learnmore.
● You may limit “prescreened” offers of credit and insurance you get based on
information in your credit report. Unsolicited “prescreened” offers for credit and
insurance must include a toll-free phone number you can call if you choose to remove
your name and address form the lists these offers are based on. You may opt out with the
nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).
● The following FCRA right applies with respect to nationwide consumer reporting
agencies:
CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE
You have a right to place a “security freeze” on your credit report, which will
prohibit a consumer reporting agency from releasing information in your credit
report without your express authorization. The security freeze is designed to prevent
credit, loans, and services from being approved in your name without your consent.
However, you should be aware that using a security freeze to take control over who gets
access to the personal and financial information in your credit report may delay, interfere
with, or prohibit the timely approval of any subsequent request or application you make
regarding a new loan, credit, mortgage, or any other account involving the extension of
credit.
As an alternative to a security freeze, you have the right to place an initial or extended
fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is
placed on a consumer’s credit file. Upon seeing a fraud alert display on a consumer’s
credit file, a business is required to take steps to verify the consumer’s identity before
extending new credit. If you are a victim of identity theft, you are entitled to an extended
fraud alert, which is a fraud alert lasting 7 years.
A security freeze does not apply to a person or entity, or its affiliates, or collection
agencies acting on behalf of the person or entity, with which you have an existing
account that requests information in your credit report for the purposes of reviewing or
2
collecting the account. Reviewing the account includes activities related to account
maintenance, monitoring, credit line increases, and account upgrades and enhancements.
● You may seek damages from violators. If a consumer reporting agency, or, in some
cases, a user of consumer reports or a furnisher of information to a consumer reporting
agency violates the FCRA, you may be able to sue in state or federal court.
● Identity theft victims and active duty military personnel have additional rights. For
more information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws.
In some cases, you may have more rights under state law. For more information, contact
your state or local consumer protection agency or your state Attorney General. For
information about your federal rights, contact:
3
TYPE OF BUSINESS: CONTACT:
1.a. Banks, savings associations, and credit unions with total a. Consumer Financial Protection Bureau
assets of over $10 billion and their affiliates 1700 G Street, N.W.
Washington, DC 20552
b. Such affiliates that are not banks, savings associations, or b. Federal Trade Commission
credit unions also should list, in addition to the CFPB: Consumer Response Center
600 Pennsylvania Avenue, N.W.
(877) 382-4357
2. To the extent not included in item 1 above: a. Office of the Comptroller of the Currency
a. National banks, federal savings associations, and federal Customer Assistance Group
branches and federal agencies of foreign banks 1301 McKinney Street, Suite 3450
Houston, TX 77010-9050
b. State member banks, branches and agencies of foreign banks b. Federal Reserve Consumer Help Center
(other than federal branches, federal agencies, and Insured State P.O. Box 1200
Branches of Foreign Banks), commercial lending companies Minneapolis, MN 55480
owned or controlled by foreign banks, and organizations
operating under section 25 or 25A of the Federal Reserve Act. c. FDIC Consumer Response Center
1100 Walnut Street, Box #11
c. Nonmember Insured Banks, Insured State Branches of Kansas City, MO 64106
Foreign Banks, and insured state savings associations
d. National Credit Union Administration
d. Federal Credit Unions Office of Consumer Financial Protection (OCFP)
Division of Consumer Compliance Policy and Outreach
1775 Duke Street
Alexandria, VA 22314
3. Air carriers Asst. General Counsel for Aviation Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
4. Creditors Subject to the Surface Transportation Board Office of Proceedings, Surface Transportation Board
Department of Transportation
395 E Street, S.W.
5. Creditors Subject to the Packers and Stockyards Act, 1921 Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies Associate Deputy Administrator for Capital Access
United States Small Business Administration
409 Third Street, S.W., Suite 8200
7. Brokers and Dealers Securities and Exchange Commission
100 F Street, N.E.
8. Federal Land Banks, Federal Land Bank Associations, Farm Credit Administration
Federal Intermediate Credit Banks, and Production Credit 1501 Farm Credit Drive
Associations McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Federal Trade Commission
Listed Above Consumer Response Center
600 Pennsylvania Avenue, N.W.
(877) 382-4357

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03/23/2022

Verifiers who have procured your data in the past 24 months -

Organization Name: Capital One (VOI Batch)

Employer Name Employer Code Employer Address

Information Current as of Employee Name Division

Original Hire Date Union Affiliation Work Location(Job site)

Next Projected Last

FEIN Employee Address Employee Phone Number Date of Birth

INCOME AND DEDUCTIONS

PAY PERIOD DETAIL 03/13/2022

HISTORICAL PAY PERIOD SUMMARY

EMPLOYER LEVEL DISCLAIMER

Employer Name Employer Code Employer Address

Original Hire Date Union Affiliation Work Location(Job site)

Next Projected Last

FEIN Employee Address Employee Phone Number Date of Birth

INCOME AND DEDUCTIONS

PAY PERIOD DETAIL 02/26/2022

HISTORICAL PAY PERIOD SUMMARY

EMPLOYER LEVEL DISCLAIMER

Employer Name Employer Code Employer Address

Information Current as of Employee Name Division

FEIN Employee Address Employee Phone Number Date of Birth

INCOME AND DEDUCTIONS

PAY PERIOD DETAIL 06/20/2021

HISTORICAL PAY PERIOD SUMMARY

EMPLOYER LEVEL DISCLAIMER

Employer Name Employer Code Employer Address

Information Current as of Employee Name Division

Next Projected Last

FEIN Employee Address Employee Phone Number Date of Birth

INCOME AND DEDUCTIONS

PAY PERIOD DETAIL 03/17/2013

HISTORICAL PAY PERIOD SUMMARY

EMPLOYER LEVEL DISCLAIMER

Right to Place a Security Freeze

How to Freeze Your Report

A security freeze request may be sent via mail to:

Equifax Workforce Solutions

You may also send a freeze request to:

A Summary of Your Rights Under the Fair Credit Reporting Act

● Consumer reporting agencies must correct or delete inaccurate, incomplete, or

● Consumer reporting agencies may not report outdated negative information.​ In

C​ONSUMERS​ H​AVE​ ​THE​ R​IGHT​ T​O​ O​BTAIN​ ​A​ S​ECURITY​ F​REEZE

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● Consumer reporting agencies may not report outdated negative information. In

CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE