Form 5208c-2 - Update Ownership Information (2009)
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1Update Ownership Information - Required for all
(Form 5208C-2)
The Amended Tax and Wage Report f orm is now available online by going
to and selecting "Find forms and publications" under "Forms".
you have not previously reported this information to the department. Your company’s business structure determines which
information you must report.
DIRECTIONS:
the box that represents your business structure*, then complete the required information for that
Check
Use black ink.
structure in the spaces below.
Sole proprietorship – include the business owner and spouse.
Partnership – include all partners.
po
and receive no compensation.
Other (please specify): ____________________ – include information for at least one contact person.
1.
Business Name
2.
Federal ID Number
3.
Preparer’s Name
4.
UBI Number
5.
Preparer’s Phone
6.
ES Reference Number
(
)
Last Name
First Name
MI
Title
Social Security Number
(
)
Address (optional)
Phone Number
E-mail
Mailing Address
City
State
Zip Code
End Date (if applicable)
FOR-PROFIT CORPORATIONS ONLY, PLEASE COMPLETE THE FOLLOWING:
Amount of stock owned:
zero percent
less than 10 percent
10 percent or more
Is this person related
cers who own 10 percent or more (i.e., parent, stepparent, grandparent,
Yes
No
spouse, children, brother, sister, stepchildren, adopted children or grandchildren)?
Last Name
First Name
MI
Title
Social Security Number
(
)
Address (optional)
Phone Number
E-mail
Mailing Address
City
State
Zip Code
End Date (if applicable)
FOR-PROFIT CORPORATIONS ONLY, PLEASE COMPLETE THE FOLLOWING:
Amount of stock owned:
zero percent
less than 10 percent
10 percent or more
Is this person related
cers who own 10 percent or more (i.e., parent, stepparent, grandparent,
Yes
No
spouse, children, brother, sister, stepchildren, adopted children or grandchildren)?
*
, scroll to the bottom of the page and select Laws & Regulations.
Send completed forms to ESD, UI Tax and Wage Administration,
Page _______
PO Box 9046, Olympia, WA 98507-9046, or fax to 360-902-9264
EMS 5208C-2 (4/09)
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