CITY OF PONTIAC - DIRECTOR OF FINANCE - INCOME TAX DIVISION                                               EMPLOYER'S FEDERAL IDENTIFICATION NUMBER
                                                                                                          (IF NOT REQUIRED - WRITE "NONE")
             EMPLOYER'S WITHHOLDING REGISTRATION
             READ INSTRUCTIONS ON THE REVERSE BEFORE FILLING OUT THIS FORM
                                                                                                                 P           -  
1. TRADE NAME
2. EMPLOYER'S NAME:
    (GIVE OWNER'S TRUE NAME IF DIFFERENT FROM TRADE NAME ABOVE)

3. ADDRESS OF PRINCIPAL PLACE OF BUSINESS

4. CHECK TYPE OF ORGANIZATION                                             OTHER               5. LOCAL TELEPHONE #              6. NO. OF EMPLOYEES
INDIVIDUAL OWNER              PARTNERSHIP CORPORATION                     (ATTACH EXPLANATION)
7. DATE BUSINESS ACQUIRED BY       MONTH  DAY                  YEAR 8. GIVE THE DATE YOU FIRST PAID WAGES           MONTH       DAY                       YEAR
    EMPLOYER SHOWN IN ITEM 2 ABOVE                                      SUBJECT TO PONTIAC WITHHOLDING
9.  WAS THIS BUSINESS PREVIOUSLY OPERATED BY ANOTHER EMPLOYER?      10.  IF ANSWER TO ITEM 9 IS "YES", GIVE EMPLOYER'S NAME AND IDENTIFICATION # IF KNOWN.
                   YES             NO

SIGNATURE                                                                 TITLE                                                 DATE
                                                                                                          P-SS-4

                                                               INSTRUCTIONS
     Each employer withholding City of Pontiac Income Tax from employees' wages should register immediately with the 
Director of Finance, Income Tax Division.  For the convenience of the employer, the Federal Employer Identification Number 
(FEIN) assigned to the employer by the Internal Revenue Service will be used for the City of Pontiac Income Tax Division 
records.  If an employer does not have a FEIN at the time of filing the City of Pontiac Income Tax Reports, application can 
be made to the Internal Revenue Service on Federal Form SS-4 for a number.

     When, for any reason, the FEIN is not required, an identification number will be assigned by the City of Pontiac Income 
Tax Division.  If an employer is assigned a FEIN at a later date, he must notify the City Income Tax Division of the FEIN 
assigned.  The employer will then be notified to discontinue the City of Pontiac Identification Number and use the FEIN for 
all future City withholding purposes.

                        Read the instructions for withholding in the City of Pontiac Income Tax Withholding Guide.

Return this form to: City of Pontiac Income Tax Division;P.O. Box;                                        530,EatonMI  48827-   Rapids0530