UC Tax Inquiry

Please provide the following information.

Required fields are marked with an asterisk(*).

First Name

Last Name

Title

Address Line 1

Address Line 2

Country

City

Zip Code

State/Province

Telephone Number

Telephone Number Ext

Requestor Type

EmployerTPA

Confirm Email

Federal Employer Identification Number

Legal Name

Account Number

Response Preference

Subject

Message

Enter the code from the image