SSN Policy Manual

Sample Letters and Forms

Terminating a Withholding Agreement If you want to address the issue of terminating your withholding agreement with the company for which you now work, this is the type of correspondence you can make to best resolve the matter. These letters work best when sent by a third party, such as an attorney. Here are two companies who can help you with these issues for a reasonable price.

Due Process, Washington P. 0. Box 248 Colbert, Washington 99005 (888) 218-7764 mail@dueprocess.org

Dr. Eduardo M. Rivera PO Box 1387 Lomita, Calif., 90717 edrivera@edrivera.com

You shouldn't need to send the bond and release agreement forms, but they are included so you will have an idea of how they appear, should the attorney prepare them for you.

Termination Letter

Social Security No. 000-00-0000

Attn:

Re: Withl~oldingAgreement

Greetings:

This statement is made pursuant to Part 3 1, Section 3402(p)-1 of the Code of Federal Regulations, paragraph b. Please terminate our withholding agreement on the last day of the last pay period in of and attach this statement to Form W-4 which 1 have previously filed with your company. This change shall terminate on December 3 1 st, . I do not wish to have any withholding fioln my paycheck between the first pay period in [month] and December 31, .

Best regards,