Form Oes-1 - Oklahoma Employment Security Commission - Employer Status Report
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1Oklahoma Employment Security Commission - Employer Status Report
1.
Business/Trade Name
Fed EIN
2.
Mailing Address
City
State
ZIP
Physical Address
City
State
ZIP
Business Telephone #
FAX #
3.
Type of Ownership
Individual
Partnership
Corporation
Governmental
LLC
LLP
Domestic
Agricultural
Non-Profit
Other (Specify)
4.
If a corporation, enter full corporate name
5.
If business is a corporation, enter date officers paid (Note: Except for an individual who owns 100% of the stock of the corporation, all
corporate officers including Sub Chapter S Corporations are considered employees for unemployment tax reporting - See Instructions)
Date
6.
Payroll records contact person
Telephone Number
7.
Date this entity first had employee(s) in Oklahoma
Date
8.
Did you acquire another business? YES
NO
Did you acquire All
Part
of the Oklahoma Operation?
Date acquired
Was the business operating at the time you acquired it? YES
NO
Name, address, and Oklahoma Account Number of Former Owner:
9.
Owners/Partners/Corp Officers
Title
Residence Address
Telephone
Stock Ownership %
Name
SSN
Name
SSN
10. A. GENERAL EMPLOYERS:
Have/do you expect to employ at least one worker in 20 different calendar weeks during a calendar year? YES
NO
th
If “YES”, enter the date of the 20
week with 1 or more employees.
Month
Day
Year
Have/do you expect to have a quarterly payroll of $1,500? YES
NO
If “YES”,
Quarter
Year
B. AGRICULTURAL EMPLOYERS:
Have/do you expect to employ in any calendar year, 10 or more agricultural workers in 20 different calendar weeks? YES
NO
th
If YES, enter the date of the 20
week with 10 or more employees.
Month
Day
Year
Have/do you expect to have a $20,000 quarterly payroll of agricultural workers in any year? YES
NO
If YES,
Quarter
Year
C. DOMESTIC EMPLOYERS:
Have/do you expect to have a $1,000 quarterly payroll of domestic workers in any year? Yes
NO
If YES,
Quarter
Year
D. NONPROFIT EMPLOYERS: Is your organization exempt from Tax under Section 1-210 (4) of the Oklahoma Employment
Security Act or under Section 501 (c)(3) of the Internal Revenue Code? YES
NO
If YES, attach a copy of your letter of
th
exemption from tax under Section 501 (c)(3) of Internal Revenue Code and enter the date of the 20
week you had at least 4 or more
workers in a calendar year.
Month
Day
Year
Please indicate the method you desire to pay contributions due. Tax Rate
Reimbursement
(See Instructions)
E. GOVERNMENTAL EMPLOYERS: Indicate the method that you desire to pay contributions due .
a. 1% Rate
b. Reimbursement
(See Instructions)
11. Do you have workers performing services for your business or in your home who you consider to be self-employed or Independent
contractors? YES
NO
If YES, see instructions.
12. Are you liable under the Federal Unemployment Tax Act? YES
NO
If YES, enter year liable
13. If you have previously filed reports to the Oklahoma Employment Security Commission, list name, address, and Oklahoma Account #:
14. Describe the exact nature of your business or employment activity and list the principal products manufactured or traded in Oklahoma:
15. Are you applying for Voluntary Election of Unemployment Tax Coverage? YES
NO
A.
The undersigned hereby voluntarily elects to become an “Employer” pursuant to the provisions of 40 O.S. Section 3-203(A),
effective
Date
B.
The undersigned hereby voluntarily elects to cover employees exempt under Section
of the Oklahoma Employment
Security Act pursuant to the provision of 40 O.S. Section 3-203(B) effective
Date
16. Signature
Title
Date
For Commission Use Only
Control Number
State No
FEIN
L-Date
E-Date
S-Date
R-Date
L-Code
Pred No
OES-1 (10-99) Equal Opportunity Employer / Programs Auxiliary aids and services are available upon request to individuals with disabilities
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