Form De 4453 - Application For Transfer Of Reserve Account
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1
2EMPLOYMENT DEVELOPMENT DEPARTMENT, MIC 4
P.O. BOX 826880, SACRAMENTO, CA 94280-0001
APPLICATION FOR TRANSFER OF RESERVE ACCOUNT
INSTRUCTIONS - Please read and complete this form carefully. If you acquired a business from an employer who was registered with
the Employment Development Department, you may apply for a transfer of all or a part of the reserve account. (A reserve account is
used to determine the unemployment insurance [UI] tax rate.) Not all reserve account balances are desirable. If the transfer of your
predecessor’s reserve account is approved, you will be subject to all or a percentage of the predecessor’s benefit charges, which could
increase your rate in future years. If you need additional information, please call (916) 653-7795, Contribution Rate Group. Failure to
completely answer all questions may result in a delay or denial of approval of this application. If more space is needed for explanation,
attach separate sheets.
ANY APPLICATION FOR
TRANSFER FILED LATER THAN
90 DAYS AFTER ACQUIRING
THE BUSINESS MAY BE
RESTRICTED.
I. Complete the following:
1. Your employer account number
2. Your name
Your federal employer identification number (FEIN)
3. Your business name
4. Your business address
ZIP
5. Name of business acquired
6. Former owner’s name
7. Former owner’s account number
8. Former owner’s business location
ZIP
9. Date of acquisition
10. Was the acquisition by
purchase $
(Check one)
merger or consolidation
stock exchange
other (explain below)
11. Please check major assets acquired
Place of business
Staff of employees
Customers
Goodwill
Trade name
Stock in trade
Accounts receivable
Tools and fixtures
12. Did you continue the operation of business you acquired?
Yes
No
If no, please explain
(See page 2)
DE 4453 Rev. 60 (3-04) (INTERNET)
Page 1 of 2
CU
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