Form K-Cns 032 - Employer Representative Authorization
Download a blank fillable Form K-Cns 032 - Employer Representative Authorization in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form K-Cns 032 - Employer Representative Authorization with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1EMPLOYER REPRESENTATIVE
KANSAS
Department of Labor
AUTHORIZATION
YOUR REQUEST WILL BE DENIED IF ANY ITEM IS INCOMPLETE
1.
KS UI Tax Account Number _________________________________
2.
Employer Name _____________________________________________________________________________________________
3.
Physical Address of Business in KANSAS. If no physical address, store front or business location exists in KANSAS, you must
indicate where in KANSAS you have workers performing a service. Do NOT use a Post Office Box Number.
Business Location
Job Site
Sales Representative Residence
Other (
)______________________________________________________________________________________
explain
__________________________________________________________________________________________________________
ADDRESS (Do NOT use PO Box Number)
CITY
STATE
ZIP
4.
Indicate the representative retained to represent you_________________________________________________________________
Indicate which Kansas Unemployment Insurance reports you have delegated the authority to receive. Provide the mailing address for
the delegated reports.
A Employer’s Quarterly Wage Report and Unemployment Tax Return, K-CNS 100
Name______________________________________________________________________________________________
Address_____________________________________________________________________________________________
City, State, ZIP+4_____________________________________________________________________________________
B Annual Experience Rating Notice, K-CNS 404, & Annual Notice of Benefit Charges, K-CNS 403
Name______________________________________________________________________________________________
Address_____________________________________________________________________________________________
City, State, ZIP+4_____________________________________________________________________________________
C Last Employer, Base Period and all other Benefit and Appeal Claim Notices
Name______________________________________________________________________________________________
Address_____________________________________________________________________________________________
City, State, ZIP+4_____________________________________________________________________________________
5.
Sign & Date
______________________________________________________________________________
_________________________
Owner, Partner, Corporate Officer, LLC Member/Manager
MM-DD-YYYY
___________________________________________________
____________________________________________________
e-mail
Telephone
Sign and return the completed report to:
Liability Determinations
Kansas Dept of Labor
Telephone .................... 785-296-5027
401 SW Topeka Blvd
Fax ............................... 785-291-3425
Topeka KS 66603-3182
e-mail ..................... uitax@dol.ks.gov
K-CNS 032 (Rev. 9-04)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal