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Get Employee Consent Form

, to file weekly claims for benefits (partials) for me in the event that the business is closed temporarily. By authorizing my employer to file these claims, I allow him to report the following information on my behalf. *Citizenship status (For employees who are not citizens, the employer will provide a copy of your alien registration card to the Payment Processing Unit. Fax number (334)242-2550. *Federal Tax Withholding preference (You may choose to have Federal Tax withheld at the rate of 10%.

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