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Get TN LB-0910 2015

NG DRIVE, 3-B NASHVILLE, TN 37243 (615) 741-2486 APPLICATION FOR CLIENT NUMBER FOR CLIENTS OF A PROFESSIONAL EMPLOYER ORGANIZATION FAX (615) 741-7214 1A. Enter Professional Employer Organization (PEO) Information Tennessee ID Number OFFICIAL USE ONLY M. No. County Alt Zip PEO State No. ___ ___ ___ ___ - ___ ___ ___ ___ PEO Name ____________________________________________ Liab. Org. First Employment Date Liable 1B. Enter Client Company Information Client’s Federal Number ___ ___ - _.

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