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Get Pa Dor 83-a272a 2017

As applicable Wage Tax Regulations. Income Tax Regulations Section 401 through 404 requires that the employer withhold and allocate wages for tax purposes. General Regulation Section 306 (2) provides that the employer, for and on behalf of the employee, requests the refund. AUTHORIZED OFFICIAL SIGNATURE (Signature must be clear and legible.) PRINTED NAME DAYTIME TELEPHONE NUMBER EMPLOYEE CERTIFICATION I HEREBY CERTIFY that the statements contained herein and in any supporting schedule or exh.

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