HomeMy WebLinkAbout1997-003 Agrmt - ADP Tax Service
Automatic Data Processing
Portland Region
10155 SE Sunnyside Road
Clackamas Oregon 97015-9765
503 654-6800
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Date: ) -2.-7_-==t:J
Co. Code: ~ \'\} t:-
Co. Name: t:t\.-\'~ l~J) a--J)_
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Dear Client:
Welcome to ADP Tax Filing Service. ADP is scheduled to commence Tax Service on the pay
date of ~ - l/ '9l -
With each payroll you will receive a "Statistical Summary", an example of which is included
with this letter. This summary details Tax Liabilities ADP will debit against your bank account
on your behalf. Each tax ADP is responsible for will be listed in a column titled "Impounded".
The total amount of this column will be withdrawn from your specified bank account the
bankinl: day before pay date. Items listed in the "Memo" column are your companies
responsibility.
The following is a list of reminders to help your tax service with ADP run as smoothly as
possible:
. Be sure that the account you have specified ADP to use for tax impounds is fund-
ed on the bankinl: day before pay date commencing with your tax service start
date -.
. Send all State Deposit Slips and Filing Fonns to ADP Tax Service as soon as you
receive them. (We will not need any Federal DeDosit SliDS or 941 forms since ADP
deposits federal tax on magnetic tape in-put).
. Notify your Client Service Representative in advance of your companies intention to
run large "bonus" payrolls.
If you have any further questions regarding your tax service please contact your Client Service
Representative.
Sincerely,
ADP Tax Service Department
FORM PR 20b8 (4/93)
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CLIENT ACCOUNT AGREEMENT AND'AUTHORIZATION TO DEBIT
(Required by Client's Bank)
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ADP
BRANCH#
Ii.
. I
COMPANY
CODE(S)
,'J K PAYROLL V,/
" TAXES
W AGE GARNISHMENT
DEDUCTIONS
FEES FOR ADP's
SERVICES
CLIENT INFORMATION
Client Name:
I"'" :
i \/ ~.,-\ I ",{ \
,--1,
Client Address:
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6J--_.
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Client Contact:
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i":. ! 'I ~ :...'
Client Phone:(.....:..J..L)
',.' ',,-
..f (--.' (j -- !;; j(> ./j
CLIENT agrees to one of the following charging methods for collection of (I) the payroll tax liabilities related to ADP's Tax
Filing Services, (2) Wage Garnishment deduction amounts from applicable employees of CLIENT and/or (3) the applicable
charges for ADP services, Such charges will be initiated by ADP, Inc, CADP") and are further defined on the back of this
Agreement.
TAX DEBIT METHOD (Check Applicable Box):
S" ACH or PRE-AUTHORIZED DRAFT
Bank is authorized to charge CLIENTs account in accordance with provisions
on the back of this Agreement.
o REVERSE WIRE
ADP will initiate a request for a wire transfer of funds from CLIENTs DDA
in accordance with reverse wire instructions on the back of this Agreement.
o DIRECT WIRE
CLIENT agrees to wire transfer funds in accordance with direct wire
instructions on the back of this Agreement.
BANK INFORMATION
PAYROLL TAX LIABILITIES:
Bank # (Transit! ABA) "
Bank Name:
Bank Address:
Bank Account #'
Bank Contact:
Bank Phone: (_)
( I,
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WAGE GARNISHMENT DEDUCTIONS:
Bank # (Transit!ABA)
Bank Name:
Bank Address:
Bank Account #'
Bank Contact:
Bank Phone: (_)
FEES FOR ADP's SERVICES:
Bank # (Transit! ABA)
Bank Name:
Bank Address:
Bank Account #'
Bank Contact:
Bank Phone: (_)
In consideration of BANK's compliance with this authorization, CLIENT agrees that BANK's treatment of any charge, and the
BANK's rights with respect to it, shall be the same as if the entry were initiated personally by the CLIENT and that if any charge
is dishonored, whether with or without cause, BANK shall be under no liability whatsoever.
In the event of any conflict between the terms and conditions of this Agreement and the terms and conditions of any Price
Quotation, National Accounts Agreement, or the ADP Terms and Conditions attached to any proposal given to CLIENT, this
Agreement shall control and govern,
This authorization shall remain in effect unless and until revoked in writing by an authorized representative of CLIENT and until
BANK and ADP have each received such notice fmd h;lVe had reasonable time to act upon such notice,
/ I , '
CLIENT Signature / // I , ' Date / /,/ /7 7
"
CLIENT Representative Name and Title l'll}" J ..'.' ,",
"' ,/<.'/-~ ~ ,/' -" ~~./ , .- ./
Bank Lead ( )YES ( )NO Lead Bank Name
(if yes, BANK name required)
TX6925 (I t/95)
(i) 1995 Automatic Data Processing, Inc.
~ "_".j L. L c: ~-: (.!
C~:.)P"{
Chent agrees 10 the foI!owing tcnns and conditions:
A,CHlPRE.AlJTHORIZlm DRAFT
CUENT lllidcfS(.iilQS lhal /\D1'\ paywiJ pruccssing dale for payro!1r' shal! oor be kss !han 24 ho(trs prior !O ,tie clwek dale and
CLl'rST aErc~~ 11'",t funds representing the tot.\\ P.iYfO\\ L\x ,mdwa~!e i::~rm<;hb'\,~n\ W'I\\ he \)ll In
CLJ[:::!';1.....; 1)1)/\ aC-2uluH \vi:h lL-:.\-NKin .sufficient aroc~unt~ioiai(':r than <)n('- biif;k1ng (lay r.r]C)f 10 the check dart' for the:
applicahk" paYtOn, (~LJEN~r ackno\.vlcdg;:>.;; thaC if suf{i(.icnt funds. t~rc tk\~ D\-niiablc, (-~ (~'L[E0:-"r \\:.iHirnrncdiah>-ly bt:~corne
rcs].i()OSihlc for ,aU lax deposits arid fjhng~~ and'",,-'agc garnif:dHll(Ont rerninanc(::,) dde; Hh:;I! and thcrc~aftcr~ and reL:lted penuhies and
intcre.st, (2,1 l!!e 'Ta.\ and Claroislnne.fu Ser'/i~:cs [nay,' be. at AJJF":,-- irnrnl:diatcly tcnn.inated. ;;lnd (J} neithe-r
BANK nor ADP will have any further ubllgalwn to CUE\'T or ;U1Y third pany I'd!ll f(;SPCC! to lhe Ta~ Filing "nj
GamJSlullcnt ServIces,
With to the for all :\DP .,T.'lvi;:C5, if sufficienr funds are nol J\ailJbk upon presentalion of such to
CLIENT's BANK, ;\DP nuy lake SUCflJCI.!"n as It deems consi:,(en! 'Nith any agreement with CLIENT
REVERSE WIRE
CTJE,;'\.~'T agrees that f'unds
date for payroUis) ~h,dl nUl be less than 24 hour;,
tax iiah] Hn.J \,.\',-tg:..: dcdu('ri;,"ins
to the \V!fC date ,~}nd
t:L~-; \VirC (r;H}'~ferT("d Jt
"i.he rc:quc:,/. c.f.Al)P frotn th~;:' CLII:}'.~'r's 1)l)A ai..'count 'v\.~l.i'! BJ\-:~5< to Banker's Trust ( iJ,. i\B/\ 0io :}.~ 1 1 {J033, i\cCi)Un!. ';'\:o
nOl 53'j (~h~t'-~C' o~~'/~:ulhanan Bank, J\.B:\!'Jo, 02100002 L /\CCotEHNu, 910.)..62S67S. (if A LH]
(r113!~~:: "'7 /\.c:_'C';J.lfH >~o. 002()(J2f)' 69 in ~un'jc~(:,n! aH~(JUiH (].rr'''~~'r's :;,;-,c:d t~,n:
,.It A[)P':,:",
!\,,'oCLHion, /I,B.:\ No,
and T\;';'3ge
dc~du,",:ti(rns n;'
!h::tn the check :1.\1t for the
'"Vlrc
p~1rt.y 10
i,,,~..-li'n!
'" r,'
,t:.n)t'nt :,\.~r'lJl((''': pu
~U~irH 1.u ~ln'~' }\';_~."~'
l\:Hiona! /\,CCDnnf
nther\vise~
rhe (~'LIEN"I' \vi,lJ
he( tilTh'
hrncrd I\:nlttL1nc.-.:s du~: ':h('n ~Hld thereafter ~Hld ar,}' r~'iJt~:~d
'Hid i,nrCTesL
In ( )n:"~id(,f dJhHl C>r ilL' ~hr,jjl
'\o\..:utTeeJ b\ ,.\LH) in p-rn\
';"'.l!'," tr,Jil,',;l:l' \~;['r
CUENT agft;C'S le pay;,
HI
~~ 1 0,00. fur .. h.j, ire transfer
DIRECT WIRE
ill:';'
date CUi
~,(;ai I ntY bi~
th::H1 24 hours prior 10 the v-,"frl..: date ~lnd
J(;i:Lucfi':~ns \\'i1i be \\~lr(':a(Hhfc:fr\.:.J
(,~r._IEc'<'r
(" I_I t'.0..'r
~';f: ;-)I{),,2,:}2K675, (Jf /'\I)P
(~jf;.~S~~:\"l;:\.nh.;ln ~in B~Hlk, :\B~A. 1\J.(). 021 OCKH}21. ;\.ccnunt
:\SSOCluiH'Hl,ABi\ No, 03 i375C)37~ Acc()unt :\In (F'.~20n~:O!6i) in stlfflcienr iUTHH.lnt HJ honor
and \vage garnishrneni dcduCi{o"l;~ \h)
fl.\L\Ii 1h(' clicck d~tii~~ r.~)r the
(,'l_If~':\;'-r
th~1Lir\ulfiC1CrH fund..; arc f}{)( \\'lre rra,nsicrn.:d on ;~ny i.:,uch (h<'.ck d~H\'~, {h.'~'n ut AJJP\
al1c! ADP',
to C:L.IEN'l' (iT an:,.. third pnITY to pn)'V}{j;,:' "f;J)'~
r.;'~) a'l\' ['fIe;." ()U[1t;.~tlon,i''\.J;Jl~,(lna\ A.ccounl
or o!Lcr\\'i'~,,-:, n,J'v hc~ L.Tntina~e4J
(}arni~hin.::nt Si.::fV1.CeS pur,(\u:ant
We CLIENT will
h;:.:C~"l"I~(:'
dU
,t.nd ri
and Vi;Jg<'
rf:n.;it{;-i.nce\~ due :.h::~n :,jnd ~h-cn:"after ~rnd (iny r~'::lJr.::d
j IhJ I rHt: H:")i
;n ",1; ~ii..;C::~li',.:;n h::.>f
~Iildi~,;,~ nai
~(' u n\.'"(i
/~I)P :1)
\\'i:c It :UJ'\ Cl' sl'.f',,'il.e'~., (~rJE>.rr dgft~'~~S Hi pay J f\:.~t.." :JI
j (l.t:'l) ff'!r:~';ich V.if-:. trL\n.~lt~L
.
limited Power of Attorney and
Tax Information Authorization
~
~
(In accordance with Internal Revenue Service Revenue Procedures)
Tax FiJin Service
COMPANY BRANCH
CODE
DN .t_, '1)' "
FEDERAL ID NUMBER
TAXPAYER LEGAL NAME (Include spaces, ampersands, and hyphens. Do not enter any other punctuation.):
REPORTING AGENT: ADP Tax Services, 400 Covina Boulevard, San Dimas, CA 91773, ID # 22-3006057, 800/235-7212
ADP is hereby appointed Reporting Agent with the authority to sign and file employment tax returns and make deposits electronically,
on magnetic media, or on paper, for the above stated taxpayer to Federal, State, and Local jurisdictions. ADP is authorized as a
designee of the taxpayer to receive notices, correspondence, transcripts, deposit frequency data, or other infonnation with respect to
employment tax returns filed and deposits made by the designee.
This authorization shall include the appropriate State and Local foons and the following Federal foons, beginning with the tax period
indicated and remaining in effect through subsequent periods until the taxpayer or designee notifies IRS that this authorization is
tenninated or revoked. If the taxpayer is required to file a return electronically or to submit federal tax deposit data electronically,
ADP is required to file the return and submit the deposit data electronically for the taxpayer. If the taxpayer is not required to file or
deposit electronically, ADP may file or make deposits on their behalf in one of the filing methods indicated below:
Forms 940 941 943 945 FTD
Filing Method E,M,P E,M,P E,M,P E,M,P E,M
Beginning Period (Tax Year) (Qtr/Yr) (Tax Year) (Tax Year) (Qtr/Yr)
/ ; J ~/~
--I
E = Electronic
M = Magnetic Media
P = Paper
The Limited Power of Attorney and Tax Infonnation Authorization revokes all earlier tax filing powers of attorney and tax information
authorizations on file with respective taxing authorities with respect to the same tax matters and tax periods covered hereby, but has no
effect on any other Power of Attorney or authorization.
Signature of Taxpayer or Authorized Representative
I understand that this authorization does not absolve me as the taxpayer of the responsibility to ensure that all returns are filed and all
taxes are paid on time. I authorize the taxing authorities to disclose otherwise confidential tax information to ADP as necessary to
discuss or provide filing or account information relating to employment tax returns filed or to be filed and/or deposits made or to be
made by ADP (including infonnation relating to any penalty resulting from such deposits) as well as deposit requirements. I certify that
I have the authority to authorize the disclosure of otherwise confidential tax data on behalf of the taxpayer.
Name (Required)
... i) Ii f (, -I- () e. n P j:'" / /1/ L) j</ (',C
Title (if applicable)
Signature (Required) /./" /'/7-- . " '.
f." {I . /({/; i,.'/'-
~~./
Reporting t Signature
/'
Date (Required)
//9/f'Q
TX693 1 (9/96)
White-Tax Legal Copy/Taxing Authority
Pink-Client Copy
Yellow-Payroll Center Copy
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Tax Filing Service
Client Analysis
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THIS DOCUMENT IS REQUIRED TO EVALUATE YOUR QUALIFICATIONS FOR ADP TAX FILING SERVICE
1. Do you have a Federal 10# (as opposed to an "applied for" status)?
2. Are any of your employees subject onlv to Medicare, and not to Social Security?
3. Does each ADP control represent only one FederaIID#? (Multiple controls per 10 are accept-
able; multiple IDs per control are prohibited).
4. Are all employees and/or payrolls for these employer identification numbers processed in the
same ADP Payroll Center (as opposed to confidential or manual payroll processed by another
system or in another ADP location)?
If no, where are the other payrolls processed?
I
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5, Is it acceptable to have your tax quarter closed no later than 3/31, 6/30, 9/30, and 12/31
and to include all check dates in their respective quarters? Adjustments must be made
before the last day of quarter and a payroll period ending 3/31 with a check date of 4/3
would be a second quarter pay,
6. Indicate which one of the following returns is your required form for Federal quarterly re-
porting purposes:
~941 _941E _943 _(other)
7. Wages paid through this ADP control are reported on a:
(CHECK ALL THAT APPLY) ~W-2 _ 1099R _1099
(other)
8. Does your company deduct backup withholding from interest, dividends, early IRA disburse-
ments, etc., due to a depositor's missing Social Security Number (primarily used by financial
institutions and credit uhions)?
9. Does your company use the standard state and SUI forms for quarterly filing purposes (as
opposed to a special filing form due to special exemption, special status, etc.)?
10. Other than exempt status, do you have a special arrangement with a state unemployment
agency to report wages paid without depositing taxes (you have a zero experience rate and
reimburse the state when there is a claim)?
11. Do you have a voluntary or private plan for employee SUI or SOl?
If yes, which state(s)
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.
12. Is your company exempt from any employer or employee payroll tax?
If yes, which tax or taxes? o' " .,.r-
13. As one of your company benefits, do you pay any of your employees' taxes?
If yes, which tax or taxes? ( " .i(l/ 4' t'. ,j (" ,L>) ,..'/)
14. Does an "outside or third party" issue your sickpay payments?
If yes, does the outside party produce W-2s reflecting those wages?
15. Do any of the states in which you are doing business require county or establishment
reporting?
If yes, attach a listing of the counties/establishments for each required state, ADP will either
provide you with a report for your use or include this breakdown in your filing(s).
//9.////-'
, Date
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PR 6136 (11/91)
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ADP Representative
@ 1991 Automatic Data Processing, Inc.
CUEfl.IT COPY
Answer
(Yes or No)
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