Date (Month Day, Year) - Lehigh Valley Health Network



RE: Refund Claim of FICA Taxes Paid During Your Medical Residency

Dear :

Lehigh Valley Health Network is in the process of filing a refund claim of FICA taxes paid on your wages earned during your medical residency. However, in order for you to join the claim, we must have a signed consent form from you.

We have engaged Deloitte Tax LLP to handle this refund claim for us. As such, if you have any questions about the claim, please email, call, or fax Deloitte Tax LLP directly.

Deloitte’s Contact Information:

• Email at: LVHNFICA@

• Call at: 1-877-355-6080

• Fax at: 866-914-0224

A consent package was mailed to you by Deloitte Tax LLP during the week of December 23, 2010 with an original due date of February 10, 2011. If you have not received a consent package, or may have discarded the one you received, you may download one from the Lehigh Valley Health Network website taxrefund. We will also periodically post updated information regarding the FICA claim on the Lehigh Valley Health Network website.

We are requesting that you complete and return your consent no later than February 25, 2010. Please note that there is no guarantee that additional extensions of time will be available.

Sincerely,

James P. Orlando, Ed.D

Director, Medical Education Development and Student Affairs

Assistant Professor of Education

University of South Florida College of Medicine

Adjunct Professor of Management

Moravian College MBA

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James P. Orlando, ed.D

Director, Medical Education

1247 South Cedar Crest Blvd

Allentown, PA 18103

ph. 610-402-2602

james.orlando@

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