Form De 1gs - Governmental Organizations, Public Schools, And Indian Tribes Registration And Update Form - 2015
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1
201GS11151
GOVERNMENTAL ORGANIZATIONS, PUBLIC SCHOOLS, AND INDIAN TRIBES REGISTRATION
AND UPDATE FORM
Did you know you can register online anytime? The Employment Development Department (EDD) e-Services for Business online
application is secure, saves paper, postage, and time. You can access the online application at
and follow the easy step-by-step process to complete your registration.
Review the instructions prior to completing this form. Do not submit this form until you have paid wages in excess of $100 to one or
more employees in any calendar quarter. Additional information about registering with the EDD is available online at
Important: This form may not be processed if the required information is missing.
A. I WANT TO
Register for a New Employer Account Number (Go to Item B.)
(Select only
one box then
Existing Employer
(Enter Employer Account Number when reporting an Update,
complete the
–
–
Account Number:
Purchase, Sale, Reopen, Close, or Change in Status.)
items specified
for that selection.)
Update Employer Account Information
Address (L, M)
DBA (I)
Add/Change/Delete Principal Offer/Administrator (G)
(Provide the Employer Account Number at the top of Item A, then complete the Items identified above and Item Q.)
Effective Date of Update(s): ____/____/______
Report a Purchase of Business
Date of Purchase
Purchase Price
Entire Business Purchase
(Provide the Seller’s Employer
Account Number at the top of Item A.) ____/____/______
$______________
Partial Business Purchase
Report a Sale of Business
Date of Sale
Entire Business Sold
(Provide Seller’s Employer
Account Number at the top of
____/____/______
Partial Business Sold
Item A. Complete Item M.)
Reopen a Previously Closed Account (Provide the previous Employer Account Number at the top of Item A then go to Item B.)
Close Employer Account
Reason for Closing Account
Date of Last Payroll
(Provide the Employer Account
No longer have employees
Number at the top of Item A.)
Out of Business
____/____/______
Report a Change in Status: Business Ownership, Entity Type, or Name
Reason for Change:
Change: From
To
(Provide the Employer Account Number at the top of Item A, and complete the rest of the form.)
Effective Date of Change: ____/____/______
B. EMPLOYER TYPE
Public/Charter School
Indian Tribe
State Colleges
(Select type then
proceed to Item C.)
Public Entity
State Hospital
District Hospital
University of California
District Fair
Federal-State Withholding
C. TAXPAYER TYPE
School District
Governmental
Other (Specify)
(Select only one
type.)
D. FIRST PAYROLL
First payroll date wages paid exceeded $100: ____/____/______ (Wages are all compensation for an employee’s
services.) Refer to Information Sheet: Wages
[DE
231A] and Information Sheet: Types of Payments
[DE
231TP] at
DATE
(MM/DD/YYYY)
E.
School Employees Fund
WOULD YOU LIKE INFORMATION ON THE FOLLOWING ALTERNATIVE
Reimbursable Cost of Benefits
Election of Disability Coverage
No, assign tax-rated method
UNEMPLOYMENT INSURANCE FINANCING?
F.
LOCATION OF
Do you have employees working in California?
Yes
No
EMPLOYEE
SERVICES
Do you have employees residing in California that are working outside of California?
Yes
No
DE 1GS Rev. 9 (11-15) (INTERNET)
Page 1 of 4
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