Number of employees:

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* 1. Number of employees:

Average starting wage:

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* 2. Average starting wage:

Number of locations and Gross Annual Sales at each location:

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* 3. Number of locations and Gross Annual Sales at each location:

Industry segment:

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* 4. Industry segment:

Company Type:

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* 5. Company Type:

What changes, if any, did you make (or will be making) as a result of the new minimum wage laws:

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* 6. What changes, if any, did you make (or will be making) as a result of the new minimum wage laws:

What other information would you like to share with the CRA about the changes to the minimum wage?

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* 7. What other information would you like to share with the CRA about the changes to the minimum wage?

Your information:

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* 8. Your information:

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