Payroll Billing - Enrollment Form

FIRM INFORMATION:

Firm Name: Payroll Firm Name: (Doing Business As) if different from Firm Name

Thomson Reuters Firm ID Number:

LOCATION INFORMATION:

Address: City:

State: ZIP Code:

CONTACT INFORMATION:

Contact Person: Job Title:

Phone Number: Email Address:

Thomson Reuters Payroll Platform:

Number of Payroll Clients:

"The Hartford" is The Hartford Financial Services Group, Inc, and its subsidiaries.

Thomson Reuters (Tax & Accounting) Inc. ("TRTA") is pleased to present the products and services of The Hartford. Geared toward TRTA's CS Professional Suite and myPay Solutions users, The Hartford's offerings can enhance your client relationships and make it more profitable, more convenient, and easier to offerpayroll services. TRTA does not endorse the Hartford products and services, and TRTA's CS Professional Suite and myPay Solutions do not require use of The Hartford products or services to perform pursuant to the TRTA product specifications.You assume sole responsibility and the entire risk as to the suitability and results obtained from use of the products and services.The products and services are in no way substitutes for assistance from legal, tax, accounting, or other qualified professionals.If legal advice or other expert assistance is required, the services of a competent professional person should be sought.