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* 1. Number of employees:

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* 2. Number of employees paid minimum wage:

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* 3. Average starting wage:

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* 4. Number of locations:

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* 5. Gross annual sales at each location:

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* 6. Industry segment:

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* 7. Company Type:

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* 8. What changes, if any, do you anticipate making as a result of the new minimum wage laws:

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* 9. Your information:

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