Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your online editor.
2. In the section for employer business name, input the full legal name of the employer as registered with the Federal ID.
3. Provide the employer's business street address, ensuring to avoid using a P.O. Box. Include the second line of the address if necessary.
4. Fill in the city, state, and ZIP code fields accurately to ensure proper location identification.
5. Identify the municipal location of the business by entering the corresponding PSD code, employer account number, and Federal ID number.
6. State the total number of W-2 withholding statements that will accompany the report.
7. On Line 2, enter the total income tax withheld from all wages during the year as reflected on the W-2 forms.
8. On Line 3, document the total quarterly income tax from wages reported on quarterly returns.
9. If there is any difference between the amounts on Lines 2 and 3, provide a clear, detailed explanation in an attached statement.
10. Complete the declaration by providing information for the primary contact individual, including their name, title, phone number, email address, and signature. Be sure to also include the date of completion.
11. After filling out all necessary sections, save your changes, then download, print, or share the completed form as needed.

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