PRIVATE TRUST INDENTURE CONTRACT
Steps 1 – 4
PART 4: Correct the W4 if you are a W2 employee according to 26 CFR § 31.3402(p)-1 by drafting the
following statement and attaching to your W4 with Human Resources to keep on file. Be sure to write
EXEMPT on line 4c of the W4. There will be no dependents to claim! Remember if your employer refuses to
attach your statement, it is discrimination against your religious rights protected by The Equal Employment
Opportunity, Section 703 of the 1964 Civil Rights Act.
VOLUNTARY WITHOLDING STATEMENT
26 CFR § 31.3402(p)-1
Date: Month Day Year
Last Name, First Name Middle c/o: 1234 Main Street
City, State
Employer Name
1234 Main Street
City, State
Ro: Employer-Employee Agreement
I, Last, First Middle (SS#: 123-45-6789), hereafter referred to as "ASSIGNOR", a free inhabitant
Oregonian National and one of the People of California State and Settlor of the Wayne Universal
Express Trust Enterprise, hereafter referred to as
'ASSIGNEE", accept full- time or part-time employment with "EMPLOYER NAME" for an annual
salary of $120,768 or hourly wage of $47/hr or agreed commission rate of #% delivered weekly or bi-
weekly as of this day. This Statement, according to the rules of 26 CFR § 31.3402(p)-1, shall officially
serve as my declaration that I do not request any voluntary withholdings from my salary, wages or
commissions and this Statement shall remain as part of the W-4 Form without a date of termination.
TAKE NOTICE, I hereby accept EMPLOYER NAME" acknowledging my religious rights
provided under TITLE VII - EQUAL EMPLOYMENT OPPORTUNITY, Section 703 of the Civil
Rights Act of 1964, to provide the terms of my compensation as an
"assignment" within this Statement, constituting part of the W-4 Form.
The amount of this assignment (100% of salary, wages or commissions) and said assignment is
made without guarantee of specific amounts, if any, to be received in any given pay period. The
ASSIGNEE shall withhold and pay, and fully indemnify ASSIGNOR from all applicable federal, state
gifts or bequest (15 U.S.C. § 1523), if any, owed by ASSIGNOR, including sales tax. Upon request
ASSIGNEE shall provide ASSIGNOR with an opinion of counsel acceptable to ASSIGNOR that such
liabilities have been satisfied.
I declare (or certify, verify, or state) under penalty of perjury under the laws of the United States
of America that the foregoing is true and correct.
Executed on________________________
__________________________________
Last, First Middle – Settlor
NOTE: Only deliver the W-4 with this Statement after you have obtained the Enterprise EIN
and opened its Trust Account.
W9 form to fill with Trust Enterprise account opening:
Box 1: Enter the NAME EXPRESS TRUST ENTERPRISE
Box 2: Enter NAME of LLC or Corp OR FIRST MIDDLE LAST for employee
- Note: When opening a Trust Bank Account bring the DBA's
Box 3: Check Trust/Estate
Box 4: Enter payee tax-exempt code TEFRA
Box 5 & 6: Enter the business address
Followed by the Trustee Signature. It will be your signature because you are the hired Co-
Trustee working on behalf of the Sole Trustee (nonresident alien).
