UCE-151
(Rev. 12/2016)
Page | 3
SECTION 4: Acquisitions, Transferred Assets, Mergers or Other Changes in Ownership
20. Check all that Apply:
☐
☐
☐
Reorganization
Purchase assets of business
Other (explain):
☐
☐
Repossession
Purchase assets of business from the
☐
Transfer of trade or business
bankruptcy court
☐
☐
Merger
Change or entity (e.g., proprietorship to
☐
Lease of business to new
corporation)
☐
business
Sale of business to new business
☐
Transfer or workforce (employees)
21. What portion of the previous owner’s assets, trade or business, or workforce was or will be obtained?
___________% of assets___________% of trade or business___________% of workforce (employees)
22. Name or former owner(s):
23. Former owners federal ID number
(FEIN)(if known):
24. SC Unemployment (DEW) account
number (if known):
25. Former owner’s address:
26. On what date did you acquire or transfer
______ /______ /______
the business?
MM /
DD / YYYY
SUTA DUMPING IS A CRIME: Any person or tax return preparer who knowingly violates or attempts to violate S.C. Code Ann.
§ 41-31-125 may be subject to civil and criminal penalties (see instructions).
SECTION 5: Other Provisions
☐
27. Have you or will you issue a 1099-Misc. forms for workers who performed services for you? (If yes,
Yes
please list names and addresses on a separate sheet.)
☐
No
28. Please provide the name and address of the financial institution through which you will maintain your business checking account.
Name
Street address
City
State
Zip Code
Corporate Officer/Business Owner Election: If the employing unit is a corporation, and wishes to elect to exempt ALL corporate officers
performing services in South Carolina from unemployment insurance coverage or if employing unit is a business entity other than a
corporation, that wishes to elect to exempt business owners (defined by S.C. Code Ann. § 41-27-265 as owning at least 25% of the entity),
Please visit
for the necessary forms to complete the process of opting out. (If you have questions about
the law, please visit, )
Be sure that all applicable items are completed before signing
THIS FORM MUST BE SIGNED BY AN OWNER, PARTNER, OR CORPORATE OFFICER. ALL OTHERS MUST HAVE WRITTEN
AUTHORIZATION COMPLETED BELOW
I certify that the information entered on this form is true and accurate, and that I am authorized by the named employing unit to complete
this report for determining unemployment tax liability.
Signature:
Print Name and Title:
Telephone:
Date:
You may complete and submit this form online at:
Or, you may complete this form and mail it to:
Employer Tax Services; PO Box 995; Columbia, SC 29202