Information Collection
Form 2678 - Employer / Payer Appointment of Agent
IC 17366 under ICR 202102-1545-010 · OMB 1545-0748.
Documents and Forms
| Document Name | Document Type |
|---|---|
Form 2678 - Employer / Payer Appointment of Agent |
Form and Instruction |
Form 2678.pdf | Form and Instruction |
Form 2678.pdf | Form and Instruction |