法律涉外文書：會(huì)計(jì)師證明函
Lawyer Attestation letter

　　I am: A Certified Public Accountant (CPA), or An Attorney

　　Name: _______________________________________________________________________

　　Firm Name: __________________________________________________________________

　　Firm Address: ________________________________________________________________

　　Telephone Number: ___________________________________________________________

　　Professional License and/or Association Number(s): _________________________________

　　This letter of attestation is being provided on behalf of the following business entity:

　　Group's Name: ________________________________________________________________

　　Group's Address: ______________________________________________________________

　　Group's Telephone Number: ____________________________________________________

　　Group Officer's Name (from whom you received the written documentation reviewed in connection with this letter of attestation): __________________________________________

　　This group is a new business, which started on __________________ and will be filing tax documents, which will be sent to you at a future date.

　　I certify that this group has a New York situs, and is a:

　　> Sole Proprietorship, and the proprietor works a minimum of 20 hours per week.

　　> Partnership

　　> Corporation

　　> Limited Liability Company (LLC)

　　> S-Corp

　　> Other Type of Business Entity (explain) ___________________________________________

　　(Please attach copies of supporting documentation)

　　The following employees of this firm began working for this company on the following dates, and are working full-time (20 hours or more per week), and will be shown on future tax documents which will be provided to you.

　　　　　　Name　　　　　　　　Start Date　　　　　 Name Start　　　　 Date

　　________________________ ________ ___________________ _________

　　________________________ ________ ___________________ _________

　　I hereby certify that the information I have stated above are true statements based on documentation provided to me. I hereby make this certification to induce X Company to offer health insurance coverage to this group based upon the information contained in my certification. I understand that X Company will retain this letter and any attached materials without regard to the acceptance or non-acceptance of the group‘s application for coverage.

　　Signature:_________________

　　Date: ____________________