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The following will serve as an example A B C PO Box 1408 Cheyenne WY 82003-1408 Fax 800 921-9651 EMPLOYER INFORMATION Federal Employer ID Number FEIN Please use the same FEIN that appears on your quarterly wage reports you submit to the State Employer Name Employer Address Please indicate the address where the Income Withholding Order should be sent. Employer City Employer State Employer Phone optional Extension Zip Code 5 digit Employer Fax optional Email Employee Social Security Number SSN - ...

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