Model Statement of data for payroll taxes

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Your employer or the benefits agency withholds payroll taxes on your wages or your benefit payment. Payroll taxes consist of wage tax/national insurance contributions, employed person's insurance contributions and income dependent contributions to the Healthcare Insurance Act. To withhold payroll taxes your employer or the benefit agency needs your personal data. You provide them on this form. Also, you specify if you want your employer to take into account the payroll tax reduction.

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