Form Uce-151 - Employer Status Report Page 3

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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

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