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Form 2678 (Rev. October 2007)
ICR 200806-1545-026 · OMB 1545-0748 · Object 7577601.
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Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Form 2678 (Rev. October 2007) |
| Subject | Employer/Payer Appointment of Agent |
| Author | SE:W:CAR:MP |
| File Modified | 2007-10-31 |
| File Created | 2007-10-29 |
| Conversion State | complete |