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Confirmation of Employer’s Quarterly Federal Tax Return Datain connection with theCoronavirus Economic Relief for Transportation Services (CERTS) ActTo be completed by Payroll Service Providers (PSP), Certified Professional Employer Organizations (CPEO), and other authorized agents.To the U.S. Department of the Treasury: I am an authorized representative of the following company:Name of PSP / CPEO / Agent: My company acts as a third party to file IRS Form 941 data for the following CERTS applicant:Name of Company: TIN of Company: For Q1 2020, the CERTS applicant identified above reported to the IRS the following number of employees and total wages, tips, and other compensation:Number of Employees: Wages, Tips, and Other Compensation: Sincerely,Signature: __________________________________Name: Title:Date: ................
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