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COUNTY OF HAWAII AUTHORIZATION/CANCELLATION OF PAYROLL DEDUCTION Employee: Last Name, First Name, Middle Initial Employee # Department/Division The undersigned hereby Assigns Cancels Changes (CHECK
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Begin by entering the current date on the designated line.
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Fill in your first and last name on the corresponding spaces.
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Provide your contact information, including your address, phone number, and email.
04
Indicate the purpose of the authorization by writing a brief description.
05
Specify the start and end dates during which the authorization is valid.
06
If applicable, include any restrictions or limitations to the authorization.
07
Sign and date the form to confirm your agreement and understanding of the authorization.

Who needs 3058 - authorization and:

01
Individuals or organizations that require permission or consent from someone else to perform a specific action.
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Employers who need employees to authorize certain activities or processes.
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Medical professionals who require patients to grant consent for medical procedures or treatment.
04
Educational institutions that need authorization from parents or guardians for students' participation in certain activities.
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3058 - authorization is a form required by the IRS for taxpayers to authorize someone else to discuss their tax situation or represent them before the IRS.
Taxpayers who want to authorize someone else to discuss their tax situation or represent them before the IRS are required to file Form 3058 - authorization.
To fill out Form 3058 - authorization, taxpayers need to provide their personal information, information about the authorized representative, details of the authorization request, and sign the form.
The purpose of Form 3058 - authorization is to allow taxpayers to grant permission to another individual to represent them or discuss their tax matters with the IRS.
Form 3058 - authorization requires information such as taxpayer name, Social Security Number, details of the authorized representative, specific matters being authorized, and signatures.
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