Form Deed-13 - Report To Determine Liability For Unemployment Tax - Sole Proprietor - Partnership - Llc - 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 ______________________________________
� Individual
� Partnership
� Limited Liability Company (LLC)
5. Type of ownership (check one)
�  Other explain: ____________________________________________________
6 Date business began operating ________________________________________
NOTE: CERTAIN KINDS OF SERVICES ARE NOT CONSIDERED EMPLOYMENT. FOR MORE SPECIFIC INFORMATION REFER
TO PUBLICATION MDES-130 MINNESOTA EMPLOYER'S UNEMPLOYMENT HANDBOOK OR OUR WEBSITE.
7. Date employee(s) first performed services outside Minnesota. If none, enter "none".
Date of first services outside Minnesota
Date of first services in Minnesota
8. Date employee(s) first performed services in Minnesota. If none, enter "none".
9. Date first wages were paid for services performed in Minnesota. If none, enter
Date wages were first paid in Minnesota
"none".
10. PHYSICAL LOCATION(S) of business in Minnesota. Do not use a post office box. Attach an extra sheet for additional locations.
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 SOLE PROPRIETOR - PARTNERSHIP - LLC
CONTINUED ON PAGE 2
(rev. 01-01)

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