RECORD OF EMPLOYMENT (ROE) OFFICE COPY ONLY

1 SERIAL NO.
2 SERIAL NO. OF ROE AMENDED OR REPLACED
3 EMPLOYER'S PAYROLL REFERENCE NO.
N/A N/A
4 EMPLOYER'S NAME AND ADDRESS
5 CRA BUSINESS NO.
SR IT SECURITY INCORPORATED 786239897RP0001
2510 - 215 QUEEN ST W 6 PAY PERIOD TYPE

TORONTO S - Semi-Monthly
ON, Canada 7 POSTAL CODE 8 SOCIAL INSURANCE NO.

M5V 0P5 951-079-839

9 EMPLOYEE'S NAME AND ADDRESS
10 FIRST DAY WORKED CCYY-MM-DD
Harmandeep Singh
7 Mabelle Avenue, Unit-2803 11 LAST DAY FOR WHICH PAID CCYY-MM-DD

Etobicoke
ON, Canada 12 FINAL PAY PERIOD ENDING DATE CCYY-MM-DD

M9A0C9
2022-12-31
13 OCCUPATION
14 EXPECTED DATE OF RECALL CCYY-MM-DD
 UNKNOWN NOT RETURNING

15A TOTAL INSURABLE HOURS

ACCORDING TO CHART ON PAGE 2 240 16 REASON FOR ISSUING THIS ROE

15B TOTAL INSURABLE EARNINGS FOR FURTHER INFORMATION, CONTACT

ACCORDING TO CHART ON PAGE 2
$ 6000.00
Rakesh Sood
TELEPHONE NO. (647) 400-9640 Ext.
15C THE FIRST ENTRY MUST RECORD THE INSURABLE EARNINGS FOR THE
FINAL (MOST RECENT) INSURED PAY PERIOD. ENTER DETAILS BY PAY
PERIOD AS PER THE CHART ON PAGE 2. 17 ONLY COMPLETE IF PAYMENT OR BENEFITS (OTHER THAN REGULAR PAY) PAID IN
OR IN ANTICIPATION OF THE FINAL PAY PERIOD OR PAYABLE AT A LATER DATE
INSURABLE INSURABLE INSURABLE A - VACATION PAY
P.P. P.P. P.P.
EARNINGS EARNINGS EARNINGS
$
1 2000.00 2 2000.00 3 2000.00
START DATE (CCYY-MM-DD): END DATE (CCYY-MM-DD):
4 5 6
B - HOLIDAY PAY FOR
7 8 9 CCYY-MM-DD CCYY-MM-DD

$ $
10 11 12
$ $
13 14 15
$ $
16 17 18 $ $
19 20 21 $ $
C - OTHER MONIES
22 23 24 $
START DATE (CCYY-MM-DD): END DATE (CCYY-MM-DD):
25 26 27
$
28 29 30 START DATE (CCYY-MM-DD): END DATE (CCYY-MM-DD):

$
31 32 33 START DATE (CCYY-MM-DD): END DATE (CCYY-MM-DD):

34 35 36

37 38 39

40 41 42 19 ONLY COMPLETE IF PAID SICK/MATERNITY/PARENTAL LEAVE OR GROUP WAGE

LOSS INDEMNITY PAYMENT (AFTER THE LAST DAY WORKED)

43 44 45 START DATE END DATE AMOUNT PER PER

CCYY-MM-DD CCYY-MM-DD DAY WEEK

46 47 48 PSL01

49 50 51 WLI01

52 53 WLI02

18 COMMENTS
MAT01

20 COMMUNICATION IS PREFERRED IN
21 TELEPHONE NO.

 ENGLISH FRENCH

22 I AM AWARE THAT IT IS AN OFFENCE TO MAKE FALSE ENTRIES AND HEREBY

CERTIFY THAT ALL STATEMENTS ON THIS FORM ARE TRUE.