Responsible Individual Personal Attestation

Request for Voluntary IRS Certification of a Professional Employer Organization (CPEO); Responsible Individual Personal Attestation

CPEO Responsible Individual Personal Attestation

Responsible Individual Personal Attestation

OMB: 1545-2266

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1545-2266 can be found here:

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Form 14737A, Responsible
Individual Personal
Attestation (RIPA)

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File Type	application/pdf
File Modified	2016-11-14
File Created	2016-11-14