W-4 Qualifying Declaration

For Personnel File The Form W-4 on file or to which this statement is attached is executed in order to provide for appropriate withholding if and when, and only if and when, I am actually paid "wages" as defined in 26 USC 3401 and 3121 by the entity to which it is furnished, which entity is legally responsible for that determination. The form is executed under the good-faith presumption that no law precludes its execution or provides for the impairment of any right or other legal infirmity of any kind, either as a consequence of its being executed by one who is not an officer, employee, or elected official of the United States, a State, or any political subdivision thereof, or the District of Columbia, or any agency or instrumentality of any one or more of the foregoing or an officer of a federally taxable corporation; or as a consequence of its being subject to the qualifications specified in this statement. In the event that such preclusion, impairment or infirmity is provided for by law, the Form W-4, and my signature thereon, are hereby declared rescinded, null, and void nunc pro tunc to date of inception. My execution of the Form W-4 on file or to which this statement is attached is not to be construed as authorizing the withholding of anything of or from what is owed to me which does not constitute "wages" as defined at 26 USC 3401 and 3121; nor as my accepting, acknowledging, declaring or establishing my status as an officer, employee, or elected official of the United States, a State, or any political subdivision thereof, or the District of Columbia, or any agency or instrumentality of any one or more of the foregoing or as an officer of a federally taxable corporation; or that of the entity to which it is submitted as an "American employer" as relevantly defined at 26 USC 3121(h)having performed public service. This statement constitutes formal notice that any assertions, explicit or implied, by the entity to which this form and statement are submitted that I have at any particular time acquired the status of an officer, employee, or elected official of the United States, a State, or any political subdivision thereof, or the District of Columbia, or any agency or instrumentality of any one or more of the foregoing or of an officer of a federally taxable corporation; or that that entity has acquired the status of an "American employer" as relevantly defined at 26 USC 3121(h) will be subject to challenge as provided for by law.
USC 26 3401 Definitions a) Wages the term wages means all remuneration (other than fees paid to a public official) for services performed by an employee for his employer. c) Employee the term employee includes [excludes all others not specifically named; Doctrine of Inclusio unius est exclusion alterius, Blacks Law Dictionary, 6th Edition; U.S. Supreme Court, Montello Salt Co. v. Utah, 21 U.S. 452 (1911)] an officer, employee, or elected official of the United States, A State [territorial possession], or any political subdivision thereof, or the District of Columbia, or any agency or instrumentality of any one or more of the foregoing. The term employee also includes [excludes all others not specifically named] an officer of a corporation.

A United States Corporation, defined in Section 207 of the Public Salary Tax Act as, a corporate agency or instrumentality, is one in which (a) a majority of the stock which is owned by or on behalf of The United States, or (b) the power to appoint or select a majority of the board of directors of which is exercisable by or on behalf of the United States. [Federal Jurisdiction only] USC 26 3402 Income tax collected at source. (p) Voluntary withholding agreements (3) Authority for other withholding [Federal jurisdiction only] The Secretary is authorized by regulations to provide for withholding A) from remuneration for services performed by an employee [federally-connected] for the employees employer which (without regard to this paragraph) does not constitute wages and B) from any other type of payment with respect to which the Secretary finds that withholding would be appropriate under the provisions of this chapter, if the employer and employee, or other person making and person receiving such other type of payment agree to such withholding. Nontaxpayer Application of the Revenue Laws and Paperwork Reduction Act The revenue laws are a code or system in regulation of tax assessment and collection. They relate to taxpayers, and not to nontaxpayers. The latter are without their scope. No procedure is prescribed for nontaxpayers, and no attempt is made to annul any of their rights and remedies in due course of law. With them Congress does not assume to deal, and they are neither of the subject nor of the object of revenue laws. U.S. Court of Claims, Economy Plumbing & Heating v U.S. 470 f. 2D 585 AT 589 (1972) The government cannot burden the exercise of a right [to work, contract or travel]. Butchers Union Co. v. Crescent City Co. 111 US 746 (1883) Tax on freedom is unconstitutional. Murdock v. Penn. 319 US 105 480-487, (1943) Income is not a private-sector common receipt. Springer v. US 102 U.S. 586 (1880) (a) no person shall be subject to any penalty for failing to comply with a collection of informationif(1) the collection of information does not display a valid control number assigned by the Director; or (2) the agency fails to inform the person who is to respond to the collection of information that such person is not required to respond to the collection of information unless it displays a valid control number. 44 U.S.C. 3512 (a)(1)(2)
______________________________________________ is a private-sector company and my remuneration is privatesector earnings not subject to withholding or any taxation, nor bound by any agreement to do so. I am domiciled in a nonfederal area within de jure state of the Union: ____________ NOT a 26 USC 7701(a)(10) state. State Check all that apply: nonresident alien per 26 USC 7701(b)(1)(B), NOT 7701(b)(1)(A) and not an individual or person per 7701(c) Minister or Ambassador of a foreign state or government as per 26 USC 892(a)(3); documentation attached W-8BEN (attached) is the only withholding form available to fill out NOT subject to 1099 reporting, withholding or backup withholding pursuant to 26 USC 3401(a)(6) and 26 CFR 31.3401 (a)(6)-1(b): Foreign persons who provide form W-8BEN are exempt from backup withholding and 1099 reporting By_________________________ (l/s lower case)

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