Fillable 13 Hr Pa Withholding Chambersburg 0 (Hagerstown Community College)

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13 Hr Pa Withholding Chambersburg 0 (Hagerstown Community College)

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Chxt,bi
CLj
HAGERSTOWN
COMMUNITY
C
0
L
L
E
G
E
1143)0
Rohrnwood
I)rive
•
Ilagerstown.
MarIand
21742-t’.514
•
301-790-28(30
Letter
of
Authorization
I.
______________________________________
authorize
Hagerstown
Community
College
to
(Employee
Name)
withhold
the
Pennsylvania
local
1.7%
tax
from
my
salary.
-
A
o
Signature
Current
Address
(including
township)
Street
City,
State,
Zip
Township
(j
4
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13 Hr Pa Withholding Chambersburg 0 (Hagerstown Community College)

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Completed 22 July 2020

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