Form C-1 - Status Report
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1
2Mail To:
Register Online at
Cashier - Texas Workforce Commission
P.O. Box 149037 - Austin, TX 78714-9037
512.463.2731
STATUS REPORT
THIS REPORT IS REQUIRED OF EVERY EMPLOYING UNIT,
AND WILL BE USED TO DETERMINE LIABILITY UNDER THE TEXAS UNEMPLOYMENT COMPENSATION ACT.
HOWEVER, IF YOU HAVE EMPLOYMENT IN TEXAS ON A FARM OR RANCH, DO NOT COMPLETE THIS FORM. PLEASE COMPLETE
FORM C-1FR, AVAILABLE ON OUR WEBSITE, TO DETERMINE IF YOU ARE LIABLE FOR YOUR FARM OR RANCH EMPLOYEES.
IDENTIFICATION SECTION
1. ACCOUNT NUMBER ASSIGNED BY TWC (IF ANY)
2. FEDERAL EMPLOYER ID NUMBER
3. TYPE OF OWNERSHIP (CHECK ONE)
CORPORATION/PA/PC
LIMITED PARTNERSHIP
4. NAME
PARTNERSHIP
ESTATE
INDIVIDUAL (SOLE PROPRIETOR/DOMESTIC)
TRUST
5. MAILING ADDRESS
LIMITED LIABILITY COMPANY
OTHER (SPECIFY)
6. CITY
7. COUNTY
8. STATE
8(a). ZIP CODE
9. PHONE NUMBER
(
)
10.
ADDRESS
PHONE NUMBER
BUSINESS ADDRESS WHERE RECORDS OR
(
)
PAYROLLS ARE KEPT:
CITY
STATE
ZIP
(IF DIFFERENT FROM ABOVE)
OWNER(S) OR OFFICER(S)
[ATTACH ADDITIONAL SHEET IF NECESSARY]
11.
NAME
RESIDENCE ADDRESS, CITY, STATE, ZIP
SOCIAL SECURITY NO.
TITLE
BUSINESS LOCATIONS IN TEXAS
[ATTACH ADDITIONAL SHEET IF NECESSARY]
12.
TRADE NAME
STREET ADDRESS, CITY, ZIP
KIND OF BUSINESS
NO. OF EMPLOYEES
IF YOUR BUSINESS IS A CORPORATION, ENTER:
13.
FILING NUMBER
STATE INCORPORATED
DATE INCORPORATED
REGISTERED AGENT'S NAME
REGISTERED AGENT'S ADDRESS
ORIGINAL CORPORATE NAME, IF NAME HAS CHANGED
EMPLOYMENT SECTION
14.
MONTH
DAY
YEAR
ENTER THE DATE YOU FIRST HAD EMPLOYMENT IN TEXAS
(DO NOT USE FUTURE DATE):
15.
ENTER THE DATE YOU FIRST PAID WAGES TO AN EMPLOYEE IN TEXAS
(DO NOT USE FUTURE DATE):
16.
ENTER THE DATE YOU RESUMED EMPLOYMENT IN TEXAS:
IF YOUR ACCOUNT
HAS BEEN
INACTIVE:
ENTER THE DATE YOU RESUMED PAYING WAGES IN TEXAS:
17.
ENTER THE ENDING DATE OF THE FIRST QUARTER YOU PAID GROSS WAGES OF $1,500.00 OR MORE:
18.
ENTER THE ENDING DATE (SATURDAY) OF THE TWENTIETH WEEK IN THE CALENDAR YEAR THAT
INDIVIDUALS WERE EMPLOYED IN TEXAS. (INCLUDE ANY WEEK IN WHICH ANYONE PERFORMED SERVICE
FOR ANY PORTION OF ANY DAY DURING THAT WEEK. THIS INCLUDES FULL-TIME, PART-TIME, PERMANENT
AND TEMPORARY EMPLOYEES. THE SERVICES DO NOT HAVE TO BE PERFORMED ON THE SAME DAY OF
THE WEEK, IN CONSECUTIVE WEEKS OR BY THE SAME EMPLOYEE. IF YOU DO NOT REACH 20 WEEKS OF
EMPLOYMENT IN THE FIRST CALENDAR YEAR OF OPERATION, BEGIN AGAIN WITH THE SECOND
CALENDAR YEAR AND COUNT UNTIL YOU REACH 20 WEEKS IN THAT YEAR. DO NOT USE FUTURE DATE)
19
IF YOU HOLD AN EXEMPTION FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION
501(C)(3), ATTACH A COPY OF YOUR EXEMPTION LETTER. ALSO, ENTER THE ENDING DATE OF THE
TWENTIETH WEEK OF THE CALENDAR YEAR IN WHICH 4 OR MORE PERSONS WERE EMPLOYED IN TEXAS:
20.
ENTER THE YEAR(S) YOUR ORGANIZATION WAS LIABLE FOR TAXES UNDER THE FEDERAL
UNEMPLOYMENT TAX ACT:
(BEGIN WITH MOST RECENT YEAR)
(YEAR)
(YEAR)
(YEAR)
(YEAR)
21.
YES
NO
DOES THIS EMPLOYER EMPLOY ANY U.S. CITIZENS OUTSIDE OF THE U.S.?
C-1 (042006) Inv. No. 518050
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