Application to Make Remittances of Source Deductions and Employer Contributions Based on Pay Periods

This form is to be used by employers that wish to receive remittance form TPZ-1015.R.14.3-V only for pay periods in which remuneration is actually paid to employees. The form may be filed only by employers that are required to make remittances of source deductions and employer contributions on a weekly basis and whose employees are paid every two weeks or twice a month.

To complete the form, save it to your computer and open it in Adobe Reader.

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2012-02 version

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