Form 150-211-157 - Change In Status Report
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CHANGE IN STATUS REPORT
Has your business name, mailing address, telephone
Has the address where your forms are
number, or federal employer identification number (FEIN)
delivered changed? Check this box and
changed? Check this box and fill in the change(s) below.
fill in the change(s) below.
Business Name
______________________________________________________
Physical or
______________________________________________________
Mailing Address
______________________________________________________
Oregon Business
Identification Number (BIN)
(
)
Telephone Number ______________________________________________________
Federal Employer
Identification Number (FEIN)
FEIN
______________________________________________________
503-947-1700
Fax to:
-or-
NATURE OF CHANGE: (Please check as appropriate) If an entity change, see instructions.
Mail to:
A. Sold, leased, or otherwise transferred:
All or
Part of the business, to:
Business Name: __________________________________________________________________________ Date of Sale: _____________________________
(
)
New Owner’s Name: ______________________________________________________________________ Telephone : ______________________________
Address: _________________________________________________________________________________________________________________________
Was business operating at the time it was sold, leased, or otherwise transferred?
Yes
No
If only part of the business was transferred, describe what was transferred: ______________________________________________________________
How many employees were transferred? ____________________________________________________
B. Partnership formed or changed. Explain on a separate sheet and attach along with a Combined Employer’s Registration form for a new partnership.
C. Corporation:
Formed
Dissolved
Ceased operations
Effective Date: _____________ Explain on a separate sheet and attach along with a Combined Employer’s Registration form for a new corporation.
Change of Officers (attach a list of officers with SSNs, home addresses, and phone numbers).
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________
Entity change from: ______________________________________________ To: _____________________________________________________________
D. Now doing business in:
TriMet and/or
Lane Transit District Effective Date: _______________________________________________________
E. No longer doing business in:
TriMet and/or
Lane Transit District Effective Date: __________________________________________________
New location: _____________________________________________________________________________________________________________________
F. Partnership, LLC/LLP, or sole proprietor operating without employees.
G. Now using leased employees: Name of leasing company ______________________________________ Date employees transferred: ______________
Total number of employees prior to transfer __________________________________________________ How many employees transferred? ________
H. Closed business or no longer doing business in Oregon.
Note: Corporate officers and members of limited liability companies are employees for some tax programs, but not in others. Check with each
agency to see if these individuals are considered employees.
Date of final payroll ____________________ Location of terminated business’ records: Name: ____________________________________________________
(mm/dd/yy)
Address _______________________________________________________________________________________________________________________________
I understand that it will be necessary for me to again report and pay taxes if at any time I resume operating, even though in a different line of business
and regardless of the extent of my employment.
(
)
X
Signature ___________________________________Title ___________________________ Date _______________Telephone No. ________________________
150-211-157 (Rev. 12-08)
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