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Get TN LB-0910 2012

OR AND WORKFORCE DEVELOPMENT DIVISION OF EMPLOYMENT SECURITY APPLICATION FOR CLIENT NUMBER for clients of a Professional Employer Organization OFFICIAL USE ONLY M. No. SIC 1A. Enter Professional Employer Organization (PEO) Information PEO State No. ___ ___ ___ ___ - ___ ___ ___ Tennessee ID# ___ PEO Name _________________________________________ Liab. Org. First Employment County Area Date Liable Rate 1B. Enter Client Company Information Client’s Federal Number ___ ___ - ___ ___ __.

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