Common Contracts
2 similar Payroll Deduction Agreement contracts
ContractPayroll Deduction Agreement • July 5th, 2017
Form 2159(November 2016) Department of the Treasury — Internal Revenue ServicePayroll Deduction Agreement(See Instructions on the back of this page.) TO: (Employer name and address) Regarding: (Taxpayer name and address) Contact Person’s Name Telephone (Include area code) Social security or employer identification number(Taxpayer) (Spouse, last four digits) EMPLOYER — See the instructions on the back of Part 2. The taxpayer identified above on the right named you as an employer. Please read and sign the following statement to agree to withhold amount(s) from the taxpayer’s (employee’s) wages or salary to apply to taxes owed.I agree to participate in this payroll deduction agreement and will withhold the amount shown below from each wage or salary payment due this employee. I will send the money to the Internal Revenue Service every: (Check one box.)WEEK TWO WEEKS MONTH OTHER (Specify.)Signed: Title: Date: Your telephone number (Include area code)(Home) (Work or business) For assistance
ContractPayroll Deduction Agreement • January 2nd, 2015
Form 2159(Rev. January 2015) Department of the Treasury — Internal Revenue ServicePayroll Deduction Agreement(See Instructions on the back of this page.) TO: (Employer name and address) Regarding: (Taxpayer name and address) Contact Person’s Name Telephone (Include area code) Social security or employer identification number(Taxpayer) (Spouse, last four digits) EMPLOYER — See the instructions on the back of Part 2. The taxpayer identified above on the right named you as an employer. Please read and sign the following statement to agree to withhold amount(s) from the taxpayer’s (employee’s) wages or salary to apply to taxes owed.I agree to participate in this payroll deduction agreement and will withhold the amount shown below from each wage or salary payment due this employee. I will send the money to the Internal Revenue Service every: (Check one box.)WEEK TWO WEEKS MONTH OTHER (Specify.)Signed: Title: Date: Your telephone number (Include area code)(Home) (Work or business) For assist
