Form Deed-13 - Report To Determine Liability For Unemployment Tax - Trust - Political Sub - Other - 2001

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REPORT TO DETERMINE LIABILITY FOR UNEMPLOYMENT TAX
MINNESOTA DEPARTMENT OF EMPLOYMENT & ECONOMIC DEVELOPMENT
UI EMPLOYER ACCOUNTS OFFICE - 390 ROBERT ST N - SAINT PAUL MN 55101-1812
TELEPHONE (651) 296-6141 Fax (651) 297-5283 TDD/TTY (651) 634-5062
INTERNET:
-
E-MAIL: deed.tax.liability@state.mn.us
1. Please enter your current business name and address here:
___________________
This is your current
Minnesota Unemployment
Tax Account Number (U.C.#).
IMPORTANT:
PLEASE FILL OUT FORM COMPLETELY. INCOMPLETE INFORMATION CAUSES DELAYS IN PROCESSING.
Completion of this form is required of all businesses operating in Minnesota. Additional information is available in the
Minnesota Employer's Unemployment Handbook (MDES-130) or on our Website:
2. Previous Minnesota Unemployment Tax account Number (U.C.#) if assigned
__ __ __ __ __ __ __
-__ __ __
3. Federal Employer Identification Number (FEIN) __ __-__ __ __ __ __ __ __
4. Business Phone Number (_______) _______-__________
E
-mail Address ____________________________________
� Trust
� Political Subdivision
� Other: explain____________________________
5. Type of ownership (check one)
6. Date business began operating
__________________________________________
Date of first services outside Minnesota
7. Date employee(s) first performed services outside Minnesota. If none, enter "none".
Date of first services in Minnesota
8.
Date employee(s) first performed services
in Minnesota. If none, enter "none".
Date wages were first paid in Minnesota
9. Date first wages were paid for services performed in Minnesota.
If
none, enter
"none".
10. Physical location(s) of business in Minnesota.
Do not use a post office box.
Attach an extra sheet for additional loc
ations.
Street Address
City or Township
State
Zip Code
County
# of Workers
11. Identify the industry and specific product or service which represents the greatest portion of your sales receipts or
revenue for each physical location in Minnesota.
Industry
Specific product or service
__________________________________________________________
______________________________________________
DEED-13 TRUST - POLITICAL SUB - OTHER
CONTINUED ON PAGE 2
(rev. 03-01)

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