Applicant Information/Information del Aplicante
Date/Fetcha: Lunes 06/16/25
Personal Information/Informacion Personal
Full Name/Nombre Completo: Villamarin villega Jackson 2
Last/Ultimo First/Primero M.I/Medio
Address/Direccion: 3426 110 st corona Apt: Beisman
New York Queens 11368
City/Ciudad State/Estado Zip Code/ Codigo Postal
Phone/Numero de telefono: 3474476099 DOB/Fetcha de Nacimiento: 09/0481
Social Security: Numero de servicio social: 797741242
Emergency Contact/Contractor de Emergencias: Elluz rojas Prima
Name/Nombre Relation/Relacion
7867991713
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: 3
Other Adjustments: Other Income/Otros Ingresos: No 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: 06/16/25
Office Usage Only/Uso de oficina solamente
Pay Rate: Start Date: Shift:
Facility: Day of the week: Manager Sign: