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

This form is for any employer required to make weekly remittances of source deductions and employer contributions that wants to receive form TPZ-1015.R.14.3-V, Remittance of Source Deductions and Employer Contributions, only for its pay periods, which are 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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2021-04 version

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