EMPLOYING AGENCY Number DateSignature Required REPORTING AGENCY Central Payroll Bureau Accounting Reporting Unit Based on my agencys request and CPBs verification a FICA credit or ID: 868060
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1 Tax Refund Record Adjustment EM
Tax Refund Record Adjustment EMPLOYING AGENCY Number: Date Signature (Required): REPORTING AGENCY Central Payroll Bureau Accounting & Reporting Unit Based on my agency's request and CPB's verification, a FICA credit or refund will be processed in the amount of calendar year, CPB is responsible for providing me a W-2c. In addition, CPB will