Form 14581 - Fslg Compliance Self-Assessment Page 14

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Page 14
Ok
Flag Item Other Tax Issues – See
Publication 15
6.
Form W-4, Employee's Withholding Allowance Certificate
Yes
No
A. Are Forms W-4 on file for every employee?
B. Are all Forms W-4 secured prior to initial payment?
Yes
No
C. Are all Forms W-4 properly completed?
Yes
No
Yes
No
D. Are new Forms W-4 secured each year from all individuals claiming to be exempt from
income tax withholding?
Notes
You have completed the FSLG Compliance Self-Assessment Tool. If you believe you have compliance issues based on your responses
above, you may wish to contact your local
IRS Federal, State and Local Government (FSLG) Office
for assistance.
14581
Catalog Number 66247V
Form
(Rev. 3-2015)

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