Form Bp A0642 PDF Details

Form BP A0642 is a form used to report the results of a compliance audit. The form is used to report on any noncompliance found during an audit, and to outline the remedial actions taken. The form can be used by organizations both in the public and private sectors. Compliance audits are conducted to ensure regulatory compliance, and can be conducted by internal or external auditors. Organizations that have a formal compliance program in place are more likely to have fewer noncompliance issues. When issues are identified, they must be promptly addressed in order to avoid any legal penalties or other adverse consequences. Use of Form BP A0642 can help organizations track their progress with regard to compliance and ultimately improve their compliance posture.

QuestionAnswer
Form NameForm Bp A0642
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesPDF, P2200, rita status certification form, BP-A0642

Form Preview Example

BP-A0642

 

 

 

JUN 10

 

 

U.S. DEPARTMENT OF JUSTICE

RELOCATION INCOME TAX ALLOWANCE (RITA) CERTIFICATION

FEDERAL BUREAU OF PRISONS

 

 

 

 

 

 

 

 

Name:

 

Phone #:

Work

Address:

 

 

Home

 

 

Soc. Sec. #:

 

 

 

Transfer Date:

 

I certify that the following information, which is to be used in calculating the RITA for which I am entitled, has been (or will be shown on the income tax

returns filed (or to be filed) by me (or by my spouse and me) with the applicable Federal, State and local tax authorities for tax year.

FILING STATUS

 

 

Single

 

Head of Household

 

Married Filing

 

Married Filing

Joint Return

 

Separate Return

GROSS COMPENSATION

 

 

*from Form(s) W-2 (including Relocation) and/or net earnings on Schedule SE (only applicable for self-employment)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Line 1 + Line 2

 

 

 

 

 

 

 

 

Forms W-2

 

 

 

 

 

Schedule SE

Employee

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

$

 

 

 

 

 

 

 

$

 

Spouse (if filing joint return)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCALITY TAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you pay a locality tax (city or county income tax)?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If so, what is the tax rate?

 

 

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the tax a percentage of

 

 

 

 

income?

 

 

state tax? or

 

 

federal tax?

 

 

 

 

 

 

 

 

* If you received relocation reimbursements for two moves

 

 

 

* From your old residence, is the distance to your new duty

during this tax year, please list the cities and states to which

 

 

 

station at least 35 miles greater than the distance to your old

you relocated.

 

 

 

duty station?

 

 

 

 

 

 

 

 

1st Move 2nd Move

The above information is true and accurate to the best of my knowledge. I/we agree to notify Relocation Services of any changes to the above (i.e., from the amended tax returns, tax audit, etc.) so that appropriate adjustment to the RITA may be made. Additional documentation will be furnished upon request.

Employee's Signature

 

Date

 

 

 

 

 

Date

Spouse's Signature (if filling joint return)

 

 

*Please be sure that all W-2 forms and Schedules (if applicable) are attached.

PDF

Prescribed by P2200