Attestation Guaranteeing the Obligations of the Professional Employer Organizations with a Professional Employer Organization Group PEO-6

Attestation Guaranteeing the Obligations of the Professional Employer Organizations with a Professional Employer Organization Group

PEO-6
I, the undersigned, do hereby attest that I represent the controlling entity of the Professional Employer Organization group. To satisfy the financial requirements of Section 31-221a et seq. of the Connecticut General Statutes, the group is submitting a combined or consolidated audited financial statement.

As the controlling entity of the professional employer group, PEO Group Name* is guaranteeing the obligations of the professional employer organization in the professional organization group.
Dated this:

MonthDayYear
Name of Controlling Entity:

First NameLast Name
Address of Controlling Entity:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Chief Executive Officer of the Controlling Entity:

First NameLast Name
Signature of Chief Executive Officer of the Controlling Entity:
Should be Empty: