Common Contracts
2 similar Payroll Deduction Agreement contracts
ContractPayroll Deduction Agreement • February 8th, 2016
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 Your telephone number (Include area code) on the right named you as an employer. Please read and sign the following statement toagree to withhold amount(s) from the taxpayer’s (employee’s) wages or salary to apply to (Home) (Work or business) taxes owed. For assistance, call: 1-800-829-0115 (Business) or1-800-829-8374 (Individual – Self-Employed/Business Owners), or1-800-829-0922 (Individuals – Wage Earners) Or write: Campus(City, State, and ZIP Code) I agree to participate in this payroll deduction agreement and will withhold the amount shown
ContractPayroll Deduction Agreement • December 30th, 2014
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 Your telephone number (Include area code) on the right named you as an employer. Please read and sign the following statement toagree to withhold amount(s) from the taxpayer’s (employee’s) wages or salary to apply to (Home) (Work or business) taxes owed. For assistance, call: 1-800-829-0115 (Business) or1-800-829-8374 (Individual – Self-Employed/Business Owners), or1-800-829-0922 (Individuals – Wage Earners) Or write: Campus(City, State, and ZIP Code) I agree to participate in this payroll deduction agreement and will withhold the amount shown
