Form 1 - Employeer'S Report Determine Liability
Download a blank fillable Form 1 - Employeer'S Report Determine Liability in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 1 - Employeer'S Report Determine Liability with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Complete and use the button at the end to print for mailing.
SD EForm -
0762
V3
HELP
FORM 1 - 2008 EMPLOYER’S REPORT TO DETERMINE LIABILITY
South Dakota Department of Labor
Unemployment Insurance Division
PO Box 4730, Aberdeen SD, 57402-4730 • Phone (605)626-2312 • Fax (605)626-3347 • Web site:
This report must be completed whether or not you are liable for contributions under the South Dakota Unemployment Insurance Laws. Completion will
help determine if you must pay state unemployment insurance taxes. Return this report within 10 days unless you receive different instructions. If you
have no employees, answer only Questions 1 through 13, sign the form on the back and return it to the above address.
1. Enter your FEIN
-
Do Not Write in This Box – For Central Office Use Only
Account Number
2. Phone Number
Ext.
2a. Fax Number
C – Number
Employer Liability
Begins
2b. Name of Contact Person
No. 21a
Applicable Rate
UI
3. E-mail Address
IF
Liability Code
Reviewer’s
& Date
Initials
4. Owner or Corporation Name
N
P
Territory
Account Code
5. Business Name or DBA
6. Mailing Address
7. Business Headquarters Address
8. Type of Ownership
1. Individual
2. Partnership
3. Corporation
4. Association
(Check One)
5. LLC
If LLC, what type of Federal Income Tax Return is filed with the IRS? 1040
1065
1120
6. Other
Explain:
State of Incorporation:
Date of Incorporation:
9.
Identification of Owner, Partners, Corporate Officers, Members, etc.
Name
Social Security Number
Title
% of Ownership
Address
10. For Corporations Only
10a. Are you a non-profit organization as described in section 501(c) 3 of the IRS Code?
Yes
No
If yes, you must submit a copy of the IRS determination letter.
10b. Have the officers received any remuneration, including dividends or other disbursements?
Yes
No
11. Have you previously reported to the SD Unemployment Insurance Division? Yes
No
If yes, enter the account number:
12. If you have or had any individuals performing services for you in South Dakota who you consider to be independent contractors or
subcontractors and not your employees, attach a separate sheet of paper listing their name, business name, address, telephone number, type
of business activity and FEIN\SS number.
12a. Do you pay any individuals for day labor, casual labor, or cash?
Yes
No
Please complete second page of form and sign
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 1 - Employer's Report To Determine Liability - South Dakota Department Of Labor And Regulation
Legal
Form 1 - Employer's Report To Determine Liability - South Dakota Department Of Labor And Regulation
Legal
Related Categories
Parent category: Legal