The second blank line allows you to report the two-digit year of the effective date. We will now provide some basic facts about the employer. Indicate whether the employer is an “individual” or a “business entity” by marking either the first control box or the second control box. Enter the employer`s full name in the blank after the phrase “. Known by the name. You must also indicate the employer`s legal address, location and land for the next three spaces. The employee must also be introduced in this paragraph. So use the following four empty fields to indicate the employee`s full name, address, city, and Land. . . .