Form Uitl-5 - Request For Seasonal Determination - State Of Colorado Page 2

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FUNCTIONALLY DISTINCT OCCUPATIONS
Please answer the following three questions for each functionally distinct occupation. If you answer “Yes” to all three
questions for any functionally distinct occupation, complete Item 3 for each specific occupation. If you answer “No” to any
of the questions for any of the functionally distinct occupations, complete Item 4 for each specific occupation.
A. Will there be seasonal periods amounting to less than 26 weeks in the calendar year during which you will
employ the total seasonal work force in any of the listed occupations?
NOTE: Less than 26 weeks means “operating no more than 181 calendar days.”
B. Will there be at least 45 consecutive days in which you will not employ workers in any of the listed occupations?
C. Will no more than 25 percent of the workers in any of the listed occupations be employed at any time following
the seasonal period?
NOTE: This figure is 25 percent of the total number of workers employed in the occupation during the seasonal
period.
3. Complete the following information for each seasonal occupation to which “Yes” was the answer for all three questions
above. If needed, this page can be photocopied or a spreadsheet with the same format may be submitted to list
additional occupations. A typed spreadsheet is preferred.
List the beginning and ending dates and the total number of workers for all seasonal periods in which the total
seasonal work force in the occupation will be employed.
List the beginning and ending dates and the total number of workers for the nonseasonal periods in which no
more than 25 percent of the workers in the occupation will be employed.
Occupational Title
Seasonal Periods
Nonseasonal Periods
(List occupational titles separately
Number of
Number of
and be specific.)
Begin Date
End Date
Workers
Begin Date
End Date
Workers
4. List all other occupations in your business and describe the job duties or activities of the occupations not listed in Item
3. If needed, this page can be photocopied or a spreadsheet with the same format may be submitted to list additional
occupations. A typed spreadsheet is preferred.
Occupational Title
Job Duties or Activities
Occupational Title
Job Duties or Activities
I certify that the above information is true, correct, and complete to the best of my knowledge.
Signature
Date
UITL-5 Reverse (R 11/2009)

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