CERTIFICATE OF NON-RESIDENCE IN THE DISTRICT OF COLUMBIA - MILLS, MONTRELL EUGENE

Document Type: 
Keywords: 
Collection: 
Document Number (FOIA) /ESDN (CREST): 
0001308797
Release Decision: 
RIPPUB
Original Classification: 
U
Document Page Count: 
1
Document Release Date: 
February 19, 2008
Sequence Number: 
Case Number: 
F-2005-00558
Publication Date: 
October 15, 1956
File: 
AttachmentSize
PDF icon DOC_0001308797.pdf35.42 KB
Body: 
 (b) (3) (b) (6) Form D-4.A Government of the District of Columbia Income Q Franchise Tax Division Washington 1, D., C., Upon request of your employer, you must file this form with him so his records may show clearly that you are not a resident of the District of Columbia. Otherwise, he must withhold D. C. income tax from your wages. EMPLOYER: Keep this certificate with your records.  If you believe the em- ployee should have filed Form D-4 in lieu of Faint D4-A, the Assessor, D. C. should be so informed. :ERTIFICATE OF NON-RESIDENCE IN   !E DISTRICT OF COLUMBIA (See instructions on reverse side) Print full name _ Montrell Ee Mi.ll9----------- Social Security No. Print address 2623 _West Newton Circle ____---city Irving --- Siaie     - I,MOntrell:eMills_ __ My permanent residence is _ 2623_West _Newton Circle :: istreetl s Irving-- --- ---- ------    Dallas       ------- (City)                                                                     ---                       -----'that (City)                                (County)       ------                    (State) I do not have a place of abode within the District; that I have not maintained a place of abode within the District for more than seven (7) months during this calendar year; that I do not reside within the District; and that I am not domiciled within the District. I certify under the penalties provided` by law that the above statements are true, correct, APPROVED  FOR RELEASE DATE:  NOV 2007