Form Ia 15 - Change Of Business Information For The Unemployment Insurance Program
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1
2NYS Department of Labor – Unemployment Insurance Division
Registration Section
IA 15
State Office Campus
(10/10)
Albany, NY 12240-0339
New York State Department of Labor
┌
┐
Employer Registration Number
Change of Business Information for the
________________________________________
Unemployment Insurance Program
Employer legal name
________________________________________
To provide corrected or new information, fill out this form and
Street or P.O. Box
send it to the address above or fax it to (518) 485-8010.
________________________________________
City
State
ZIP code
For help, contact (888) 899-8810 or
________________________________________
└
┘
Your signature is required on the back of this form.
Part A – Federal Employer Identification Number
--
1.
Enter your Federal Employer Identification Number (FEIN) if your FEIN
•
Was not previously reported
•
Is incorrect
•
You reported under an ID other than your FEIN
•
Changed because of a change in business entity
Also complete Part B
Part B – Discontinuance of Business/ Change in Ownership/Name Changes
1.
If your business or employment in NYS was permanently discontinued, provide the date this occurred:
(mmddyy)
2.
Indicate if your business in NYS was sold or transferred:
All
Part
Enter date of change:
(mmddyy)
Name of new owner:
Address of new owner:
3.
If ownership*/business entity (i.e. partnership, sole proprietor, corporation, limited liability company (LLC),
limited liability partnership (LLP) has changed, give the date:
(mmddyy)
* A corporate stock transfer or sale is not a change in ownership for Unemployment Insurance purposes.
Explain:
4.
Name changes:
A.
If your business is a corporation, LLC or LLP, you must make any legal name change with the Department of State (DOS). Contact
DOS by telephone at (518) 473-2492 or write to 41 State Street, Albany, NY 12231. DOS processes the name change and notifies us
of the change.
B.
If your business is a partnership and there is a change in partners, does your partnership agreement allow for a change in partners
without dissolving the partnership?
Yes
No
Enter date of change:
(mmddyy)
Name of new partnership:
C. If your trade name (doing business as) changed, provide the new name:
5.
If your business is a
•
corporation and there is a change in corporate officers or
•
partnership and there is a change in partners (including LLPs and RLLPs) or
•
LLC or PLLC and there is a change in members
mark if an officer/partner/member was added (Add) or removed (Del.) in the section below.
Add
Del.
Name
Social Security account no.
Title
Residence
Address corrections are on the reverse side. Sign the back of this form.
IA 15 (10/10)
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