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HomeMy WebLinkAbout1996-075 Account Agrmt - ADPClient Account Agreement (Required by Bank) CLIENT NAME -// '--,.T~/ ~ /T~ , __'~"J/L /~ .~ ( /"% GLIENT agrees to one of the following charging methods for collection of (1) the payroll tax liabilities related to ADP's Tax Filing Services and/or (2) the applicable charges for any ADP Services not covered by the provisions of clause (1) hereof. Such charges will be initiated by ADP Inc. ("ADP") and are further defined on the back of this Agreement. Check Applicable Box: ~[ACH or PRE-AUTHORIZED DRAFT- [] REVERSE WIRE -- {~] DIRECT WIRE -- BANK Information: PAYROLL TAXES: BANK # (TRANSlT/ABA): BANK NAME: /'~', , BANK ADDRESS: BANK is authorized to charge CLIENT's account in accordance with provisions on back of Agreement. ACH or Pre-Authorized Draft will be utilized for all fees. ADP will initiate a request for a wire transfer of funds from CLIENT'S DDA in accordance with Reverse Wire instructions on back of Agreement. CLIENT agrees to wire transfer funds in accordance with Direct Wire instructions on back of Agreement. BANK // ;/~' f"3 ~:' .,~ ACCOUNT #: ,/[(?.,. ?~_,., ~'~.-/.~.z./ BANK BANK PHONE:( ) FEES FOR SERVICES: BANK BANK # (TRANSIT/ABA): ACCOUNT #: BANK BANK NAME: CONTACT: BANK BANK ADDRESS: PHONE: ( ) In consideration on BANK's compliance with this authorization, CLIENT agrees that BANK's treatment of any charge, and the BANK's rights in 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 for CLIENT, this agreement shall control and govern. This authorization will remain in effect until revoked, in writing, by CLIENT. CLIENT Representative Name and Title: ,- Date: ." Bank Lead: []YES [] NO TX6925 (9/91) CLIENT Signature: .,-. Lead Bank Name: PAYROLL / (must be authorized signer on the BANK account) (If yes, BANK lead required) C 0 P Y ©t99t Automatic Data Processing, Inc. Tax Filing Service Client Analysis COMPANY NAME CO. CODE BR. NO. THIS DOCUMENT IS REQUIRED TO EVALUATE YOUR QUALIFICATIONS FOR ADP TAX FILING SERVICE 1. Do you have a Federal IDtt (as opposed to an "applied for" status)? 2. Are any of your employees subject only to Medicare, and not to Social Security? Answer (Yes or No) 3. Does each ADP control represent only one Federal ID~I? (Multiple controls ~)er ID are accept- able; multiple IDs per control are prohibited). Y 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? Y 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- pc purposes: 941 __ 941 E __ 943 __ (other) 7. Wages paid through this ADP ~.o~rol 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 unions)? 10. 11. 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.)? 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)? Do you have a voluntary or private plan for employee SUI or SDI? If yes, which state(s) 12. Is your company exempt from any emQloyer or employee payroll tax? If yes, which tax or taxes? ,/ 13. As one of your company benefits, do you Day any of your,employees' taxes? 14. Does an "outside or third party" issue your sickpay payments? If yes, does the outside party produce W-2s reflecting those wages? Y Y Y 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). Client Signature Date ADP Representative" P R 6t36 ,', 11/9! i '-~'~ 991 Automatic Data Processing, Inc CLIENT COPY Tax Filing Service Federal/State/Local s H A D E D ADP Authorization MAILING ADDRESS 15-16 18-19 AREAS FOR USE ONLY DBA MAKING FIRMLY- YOU ARE I 4 COPIES I [NAME OF CONTACT STATE ZIP ~_DE STATE ~ i .... ! PRESS CITY .,~ GITY Co'1CO3DE 4 14 TAX PREFIX P/'RFREQ. DATEISTP/RPICKUP UCM CLIENT AUTOPAYPLUS i TAX GRID P/R STATE STATE STATE INCOME TAX CODE ABBR ACCOUNT NUMBER 15-16 18-19 CA FEDERAL TAXES DEP I FIT/SS-MED STARTING FEDERAL ID # PROOF Q1 Q2 Q3 Q4 0.5 YEAR /" ~ 3435363738 39-40 STATE TAXES PROOF BE, S I T EY STATE ?A~IE UNEMPLOYMENT INSURANCE PROOF ADD'L P/R ATF'B FREQ A AIT'B. RATE SUf O1 02 03 Q4 05 R ACCOUNT NUMBER RATE COBE Qi 34 35 36 37 38 3.940 I 43 CA Q1 43 F UTA J 1 Q2 0.3 0.4 Qd YEAR j 44 45 46 4-?~L 48 49 CA SLJt ER SUI EE .... 021Q3 Q4 Q5 G11,~__O_3~ 44145 46-~,F'-~215.~ g,~lsg SDt ER SDI EE I 5 56 61 62 63 64._65i70 71 I i I i I SUB P,R P'R CARD STATE STATE CiTY CITY/COUNTY CITY/COUNTY CODE CODE ABBR. CODE NAME ACCOUNT NUMBER 1,516 17 19 2324 25 28 DA BA BA LOCAL IpR00F --- [CITY/COUNTY [JLF I IATr'° FREOIQ10Z 29 30 31 3ol33 0A i The information contained herein is furnished bv the undersigned CLIENT in accordance with the Pavroil Services/Tax Services Price Quotation between ADP and CLIENT. CLIENT understands that the action of ADP or its a~ents taken under such Price Quotation will be based on the information furnished hereto and agrees to hold ADP and its agents harmless as provided in such Price Quotation. -o~ lENTS SlGNATLJRE., - ~]ENT NAME A~ TITLE Oil./ Turner, DJr~tor of Fin~ce TAXES C~T¥ CODE 49 52 NOTE: Tax Set" (: dr] 's !:O~ ,qc[ude filin.1 q~ .de[,osi.~inO ¢)f ,'~ 'is ~ ~:ah's atm'] L¢~e r]~ ~:O~l-,'~:at£ rax.eg TAX F-IL!~G SERV CE WILL BE61N WITH O. UAF~TER_._~---,~ DATA ENTRY AUTHORIZATION KNOW ALL MEN BY' THESE PRESENTS: TIIAT TIlE UNDERSIGNEl) '~ <'"'/~' /?." .C45'~, "",:~i .:> .1~ ~ ,~'~':'does ' :7' ~ ~%/:~/.-, f '" w': .-,- .... having its principal ofl'icc at z--~ ~ _ ....... + · ',. , hereby ~onslitule and appoint A[)P, Inc., its divisions and subsidiaries the [rue and lawful attorneys-in-fact of the undersigned, until further ~ titten notice, to represent ti~c undersigned before any and all government bodies, agencies or instrmncntalities, in all matters aft'coting unemlfiOymenl insurance taxes including, without limitation, all claims, contrihutions and experience rating~ and tla0 signing of any and all documents relating thereto. Each of said attorneys-in-I'act shall laavc the power to aci with or without the others and the power and authority to l)erform, in the name and on bchall' of the undersigned, every act necessary to carry out the subject matter Incroof as fully as the undersigned could do. The undersigned hereby ratifies and approves the acts of said attorneys-in-fact. This Authorization supersedes and revokes any prior power of attorney or authorization from the under- signed relating to the subject matter befool: IN WITNESS WHEREOF, the undersigned has duly' executed and delivered this Authorization this --- day of · i ~'", Name of Cornpany (lype or print) ATTEST: :.;/ -/> , ~gnamrc I Authorizcd Officcrl Oill Turner, Director of Finance Name and Title [type or print) UC 60!8 r2.E~5, 1995 Automatic Data Processing Inc Limited Power of Attorney and Tax Information Authorization (In accordance with Internal Revenue Service regulations) Tax Filing Service FEDERAL ID NUMBER ... ~.~ ,..,~ //'/ COMPANY CODE NUMBER BRANCH TAXPAYER ('- / (LEGAL NAME) Automatic Data Processing ("ADP") is hereby appointed Reporting Agent with authority to sign and file employment tax returns and make tax deposits for the above stated Taxpayer to Federal, State and Local jurisdictions. The Reporting Agent shall also be authorized as a designee of the Taxpayer to receive returns and copies of notices, correspondence and transcripts with respect to employment tax returns filed by the designee. This authorization shall include the appropriate State and Local forms and the following Federal forms, be- ginning with the tax period indicated and remaining in effect through subsequent tax periods until notified by the Taxpayer, or the designee, of termination or revocation of this authorization. Tax Form 941 (REGULAR) Beginning Tax Period (Tax Quarter/Year) 945 (NON W-2) [] (Tax Year) 942 (HOUSEHOLD) [] (Tax Quarter/Year) 943 (AGRICULTURE) [] (Tax Year) 940 (FUTA) [] (Tax Year) This Limited Power of Attorney and Tax Information 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. TAXPAYER TX 6931 (12-93) WHITE - TAX LEGAL COPY By: Client Signature (Authorized Officer) Name and Title: (print or type) Date: WHITE - TAXING AUTHORITY (print or type) YELLOW - PAYROLL CENTER COPY :~, 1993 Automatic Data Processing, Inc. PINK - CLIENT COPY