Form 4808 - Quarterly Report Of Income Tax Withholding Received By Community College From Employer Under Agreement For New Jobs Training Program

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Michigan Department of Treasury
4808 (Rev. 4-10)
Quarterly Report of Income Tax Withholding Received by Community College
from Employer Under Agreement for New Jobs Training Program
Issued under authority of Public Act 331 of 1966.
You must report all income tax withholding received this quarter from an employer as part of an agreement under the New Jobs
Training Program (MCL 389.161-166). Mail completed form to Office of Revenue and Tax Analysis, Michigan Department of Treasury,
430 W. Allegan St., Lansing, MI 48922, or fax to 517-335-3298.
Name of Community College
Quarter Being Reported
Year
2
st
nd
rd
th
1
3
4
Withholding
Name of Employer
Agreement Number
Received
Certification: I certify under penalty of perjury the information contained on this document is true and correct to the best of my knowledge.
Signature
Title
Date

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