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Payroll Account Acknowledgment - .web

Account Name: Tax ID: Group No.: Writing No.: M-0138 6 M0138.12 Is this a leasing company or professional employee organization (PEO)? Yes No Business Type: Corporation Sub S Corporation Partnership Sole Proprietorship Other Eligibility: Indicate eligibility criteria (e.g., eligibility dates, exceptions) for your cafeteria plan.

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  Leasing

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