Form Ucs-70 - Application For Common Paymaster 2001

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UCS-70
Application For Common Paymaster
R. 08/01
Unemployment Tax account number
Complete the following for common paymaster corporation
A common paymaster is any member of a group of related corporations that disburses wages to concurrent employees
on behalf of the related corporations. Concurrent employment is subject to verification.
Owner name _____________________________________________________________________________________________
(Legal name of individual, principal partner, or corporation)
Mailing address ___________________________________________________________________________________________
(Street address, City, State, ZIP)
Payroll records maintained at ________________________________________________________________________________
Telephone number
Common paymaster effective date
Month
Day
Year
Complete the following for related corporations
If the related corporations have not been assigned an unemployment tax account number, you must complete an
Application to Collect and/or Report Tax in Florida (Form DR-1).
Unemployment Tax Account Number
Owner Name: Legal name of individual, principal partner, or corporation
Corporations shall be considered related corporations for an entire quarter, if they shall satisfy any one of the
following four tests at any time during the quarter. Please check one of the following:
1. The corporations are members of a “controlled group of corporations” as defined in s. 1563 of the Internal
Revenue code of 1986 or would be members if paragraphs 1563(a)(4) and subsection 1563(b) did not apply
(provide copy of IRS approval).
2. Fifty percent or more of the officers of one corporation are concurrently officers of the other corporation.
3. If a corporation does not issue stock, either 50% or more of the members of the board of directors or other
governing body of one corporation are members of the board of directors or other governing body of other
corporation, or the holders of 50% or more of the voting power to select such members are concurrently the
holders of more than 50% of that power with respect to the other corporation.
4. Thirty percent or more of the employees of one corporation are concurrently employees of the other corporation.
Pursuant to Chapter 443, Florida Statutes, the undersigned hereby affirms that the information given above is true
and correct and is given for the purpose of determining common paymaster status under said law and is authorized to
execute this report on behalf of the employer named.
Signature _________________________________________________
Print name _______________________________________________
Date _____________________________________________________
Official position ____________________________________________
Return address:
FLORIDA DEPARTMENT OF REVENUE
For assistance call:
PO BOX 6510
1-800-482-8293
TALLAHASSEE FL 32314-6510
INTERNET ADDRESS:

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