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Tax Status Change Request
Update your tax withholding information
Employee ID
First Name *
Last Name *
Email (for confirmation)
SSN (last 4 digits)
Effective Date
Current Filing Status
Single
Married Filing Jointly
Married Filing Separately
Head of Household
New Filing Status *
Single
Married Filing Jointly
Married Filing Separately
Head of Household
Number of Allowances
Additional Withholding ($)
Notes (optional)
I certify this information is accurate
Submit
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