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Lawyer Attestation letter

2016-02-15 11:16  來源:   糾錯

Lawyer Attestation letter

I am: A Certified Public Accountant (CPA), or An Attorney Name: _______________________________________________________________________ Firm Name: __________________________________________________________________ Firm Address: ________________________________________________________________ Telephone Number: ___________________________________________________________ Professional License and/or Association Number(s) _________________________________ This letter of attestation is being provided on behalf of the following business entity:

Group's Name: ________________________________________________________________ Group's Address: ______________________________________________________________ Group's Telephone Number: ____________________________________________________ Group Officer's Name (from whom you received the written documentation reviewed in connection with this letter of attestation) __________________________________________ This group is a new business, which started on __________________ and will be filing tax documents, which will be sent to you at a future date. I certify that this group has a New York situs, and is a:

> Sole Proprietorship, and the proprietor works a minimum of 20 hours per week.

> Partnership

> Corporation

> Limited Liability Company (LLC)

> S-Corp

> Other Type of Business Entity (explain) ___________________________________________

(Please attach copies of supporting documentation)

The following employees of this firm began working for this company on the following dates, and are working full-time (20 hours or more per week), and will be shown on future tax documents which will be provided to you. Name Start Date Name Start Date ________________________ ________ ___________________ _________ I hereby certify that the information I have stated above are true statements based on documentation provided to me. I hereby make this certification to induce X Company to offer health insurance coverage to this group based upon the information contained in my certification. I understand that X Company will retain this letter and any attached materials without regard to the acceptance or non-acceptance of the group‘s application for coverage. Signature:_________________ Date: ____________________

責任編輯:儀

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