Form Deed-13 - Report To Determine Liability For Unemployment Tax - 2003

ADVERTISEMENT

REPORT TO DETERMINE LIABILITY FOR UNEMPLOYMENT TAX
MINNESOTA DEPARTMENT OF EMPLOYMENT & ECONOMIC DEVELOPMENT
UI EMPLOYER ACCOUNTS OFFICE - 390 ROBERT ST N - SAINT PAUL MN 55101-1812
TELEPHONE (651) 296-6141 Fax (651) 297-5283 TDD/TTY (651) 634-5062
INTERNET:
1. Please enter your current business name and address here:
___________________
This is your current
Minnesota UI Employer
Account Number
IMPORTANT:
PLEASE FILL OUT FORM COMPLETELY. INCOMPLETE INFORMATION CAUSES DELAYS IN PROCESSING.
Please correct any errors in the above address or in any preprinted information below. Completion of this form is required of all
businesses operating in Minnesota. This report must be completed and returned e ven if you received your account number by phone
or if a payroll service prepares your tax reports. Additional information is available in publication DEED-130 Minnesota Employer's
Unemployment Handbook or on our website:
2.
Previous Minnesota UI Employer Account Number, if assigned
___ ___ ___ ___ ___ ___ ___
- ___ ___ ___
3.
Federal Employer Identification Number (FEIN)
___ ___
- ___ ___ ___ ___ ___ ___ ___
Business Phone Number
(_______) _____
__ - ____________
E-mail Address
__________________________________
4.
Type of business
(check
all that apply)
Date business began operating
__________________________
Individual-Sole Proprietor
Professional Association
Partnership-LP, LLP, PLLP, Joint Venture
Domestic
“S” Corporation
Limited Liability Company (LLC)
Agricultural
“C” Corporation
Nonprofit :
Political Subdivision
For above types of entities, complete:
501(c)(3) form attached
Estate
State of incorporation
_______________
501(c)(3) form pending
Trust
Date of incorporation
_______________
Cooperative
PEO-employee leasing company
Tribal Entity
Other: ____________________________
NOTE: CORPORATE OFFICERS WHO PERFORM SERVICES IN MINNESOTA ARE EMPLOYEES BY STATUTE.
Month
Day
Year
5.
Enter the date any employee(s), first performed services for this business outside Minnesota, including
corporate officer(s) or shareholder(s).
If none, enter "none"..
6.
Enter the date employee(s) first worked in Minnesota, including corporate officers or shareholders.
If none, enter “none.”
7.
Enter the date first wages were paid to employee(s), officer(s) or shareholder(s) who perform services
in Minnesota.
If none, enter “none.”
8.
DOMESTIC ONLY (refer to Instructions #8):
COMPLETE 5, 6, 7, AND
enter the date within the first
calendar quarter in which you paid gross wages of $1000 or more to domestic worker(s).
If none, enter
"none".
9.
AGRICULTURAL ONLY (refer to instructions #9): COMPLETE 5, 6, 7, AND enter:
A.
Date you had four or more employees in Minnesota during 20 different weeks in a calendar year,
excluding officers of a family farm corporation.
If none, enter “none.”
B.
Date you had ten or more employees during 20 different weeks in a calendar year anywhere in the
United States, including officer of a family farm corporation.
If none, enter “none.”
C.
Date your business paid $20,000 gross payroll in a calendar quarter to agricultural employees anywhere
in the United States (including non-cash wages in Minnesota).
If none, enter “none.”
10.
Physical location of business operations in Minnesota. Do not use a post office box. Attach extra sheet for additional locations.
Street Address
City or Township
State
Zip Code
County
# of
Workers
11.
Identify the industry and specific product or service which represents the greatest portion of your sales receipts or revenue for
each physical location in Minnesota.
Industry
Specific product or service
__________________________________________________
_________________________________________________
DEED-13
CONTINUED ON REVERSE SIDE
(rev. 09-2003)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 3