Applicant Information/Information del Aplicante
Date/Fetcha: 06/16/2025
Personal Information/Informacion Personal
Full Name/Nombre Completo: Robles Orangel A
Last/Ultimo First/Primero M.I/Medio
Address/Direccion: 625 union street Apt: 606
Brooklyn New york 11215
City/Ciudad State/Estado Zip Code/ Codigo Postal
Phone/Numero de telefono: (917)264-9006 DOB/Fetcha de Nacimiento: 11/1/1988
Social Security: Numero de servicio social: 898-49-8106
Emergency Contact/Contractor de Emergencias: Manuel cordero Cuñado
Name/Nombre Relation/Relacion
3479548267
Number/Numero
Filling Status (W4)/Estado Civil: Dependents/Dependientes:
Single or Married (separately)/Soltero o casado (por separado) Yes/Si: Si
Married (joint filing)/Casado (presentacion conjunta) No:
✅ Head of household/Jefe de hogar Amount/Cantidad: 2
Other Adjustments: Other Income/Otros Ingresos: Deductions/Deducciones:
Extra Withholdings:
Disclaimer and Signature/Descardo de Responsabilidad y Firma
By providing your information, you agree for Rightway Cleaning LLC to run a background check. By signing below, you
understand and accept the terms of this requirement and agreement. And read and agreed to all Terms and Conditions of the
Employees Handbook.
Al proporcionar su informacion, acepta que Rightway Cleaning LLC realice una verifacion de antecedents penales. Al firmar a
continuacion, comprende y acepta los terminus de este requisito y acuerdo y leido y aceptado todos los Terminos y Condiciones
del Manual del Empleado.
Signature/Firma: Date/Fetcha: 06/16/2025
Office Usage Only/Uso de oficina solamente
Pay Rate: Start Date: Shift:
Facility: Day of the week: Manager Sign: