Form Uitl-5 - Request For Seasonal Determination - State Of Colorado

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Colorado Department of Labor and Employment, Unemployment Insurance Employer Services
P.O. Box 8789, Denver, CO 80201-8789
303-318-9100 (Denver-metro area) or 1-800-480-8299 (outside Denver-metro area)
REQUEST FOR SEASONAL DETERMINATION
Mail your completed request to the above address or fax it to 303-318-9206. Unemployment Insurance Employer Services
makes seasonal determinations in accordance with the Colorado Employment Security Act 8-73-106 and the Regulations
Concerning Employment Security Part X.
Owner, Partners, or Corporate Name
Employer Account Number
Trade Name
Business Telephone Number
Street Address
City
State
ZIP Code
NOTE: Complete this section if your mailing address is different from above.
In Care of Name
Mailing Address
City
State
ZIP Code
INSTRUCTIONS
In order to be considered a seasonal employer with seasonal occupations, seasonal status must be requested and granted
prior to the beginning of a seasonal period.
If your entire business operation is seasonal, complete only Items 1 and 2 and sign on the reverse side.
If a functionally distinct occupation within your business is seasonal, complete Items 1 through 4 and sign on the reverse
side. (A functionally distinct occupation is an occupation in which the assigned duties or activities, as a whole, are
identifiably distinct under the usual and customary practice of the industry.)
1. List the calendar year for which you are requesting seasonal status
___________________________
2. Does your entire business operate for less than 26 weeks (i.e., operating no more than 181 days, including Saturdays
and Sundays) during the calendar year?
Yes (List your business’s opening and closing dates for the upcoming seasonal periods.)
If you have more than one seasonal period, please provide the opening and closing dates for each season.
Opening Date (mm/dd/yyyy)
________________________________________
Closing Date (mm/dd/yyyy)
________________________________________
Opening Date (mm/dd/yyyy)
________________________________________
Closing Date (mm/dd/yyyy)
________________________________________
No (Complete Items 3 and 4 on the reverse side of this form.)
UITL-5 (R 11/2009)

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