Instructions Employer Withholding Registration

        Each employer withholding City of Saginaw Income Tax from employees’ wages should register with 
the Income Tax Office.  For the convenience of the employer, the Federal Identification Number assigned to the 
employer by the Federal District Director of Internal Revenue will be used for the City of Saginaw Income Tax 
Office records.

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

                                                                        Employer’s Federal Identification Number
   S-SS-4                  City of Saginaw – Income Tax Office
                                Employer’s Withholding Registration 

 1. TRADE NAME: 

 2.  OWNER’S NAME:  (IF DIFFERENT FROM TRADE NAME)

 3.  MAIN OFFICE MAILING ADDRESS: 

 4.  SAGINAW ADDRESS: 
      (CHECK TYPE OF ORGANIZATION)                                                                  LOCAL TELEPHONE NO. 
 5.            SOLE PROPRIETOR             PARTNERSHIP           CORPORATION        OTHER         6.
         NO. OF EMPLOYEES     ACCOUNTING PERIOD 
 7.                       8.                   CALENDAR YEAR                    FISCAL YEAR ENDING ------------------------
       IF THIS BUSINESS WAS PREVIOUSLY OWNED BY ANOTHER              GIVE THE DATE THE BUSINESS WAS ACQUIRED BY CURRENT 
         EMPLOYER PRINT NAME BELOW.                                  EMPLOYER.       
 9.                                                               10. 
       (PAYMENT FREQUENCY )                                       (FOR INTERNAL USE ONLY) 
 11.    MONTHLY                          QUARTERLY                P I N:

                      SIGNATURE                                                             TITLE        DATE