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Refund consent form 2026
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- Click ‘Get Form’ to open the refund consent form in the editor.
- Begin by reading the statement regarding your consent for General Electric to reimburse you for FICA taxes. Ensure you understand the implications of this consent.
- In the designated field, confirm your consent by stating: 'I hereby consent to General Electric directly reimbursing me for the refund of employee FICA taxes due to me as a result of the retroactive increase of the IRS pre-tax transit benefit from $125 to $240, effective January 1, 2012.'
- Next, affirm that you have not claimed a refund or credit elsewhere by filling in: 'I have not claimed a refund or credit of the employee FICA taxes due to me as a result of this overpayment to date, nor will I separately from GE file a claim for refund or credit of such amount.'
- Under penalty of perjury, declare that your statements are true by signing in the signature field and printing your name below it.
- Enter your Employee Identification Number (SSO) and date signed in their respective fields.
- Once completed, download or save your filled form and return it to GE at PO Box 60300, Fort Myers, FL 33906-6300.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2012 | 4.6 Satisfied (66 Votes) |
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