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O. Box 25000 Raleigh NC 27640-0005 Fax 919-715-1786 PRINT CLEAR 1 Taxpayer Information Taxpayer s must sign and date this form on page 2 line 7. D Officer - a bona fide officer of the taxpayer s organization. e Full-Time Employee - a full-time employee of the taxpayer. Name and address TANYA B. NEVILLE TIME PAYROLL 2837 DAISY LANE SUITE A WILSON NC 27896 ANGIE K. LANE LINDSEY ORR Telephone No. Fax No. 252 234-2924 252 234-6010 to represent the taxpayer s before the North Carolina Department...
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