Form De 1ag - Agricultural Employer Account Registration And Update Form - 2016
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201AG11151
AGRICULTURAL EMPLOYER ACCOUNT 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,
–
–
Account Number:
complete the
Purchase, Sale, Reopen, Close, or Change in Status.)
items specifi ed
Update Employer Account Information
for that selection.)
Address (N, O)
DBA (I)
Personal Name Change (F)
Add/Change/Delete Offi cer/Partner/Member (G)
(Provide the Employer Account Number at the top of Item A, then complete the Items identifi ed above and Item S.)
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 the business’ Employer
Account Number at the top of
____/____/______
Partial Business Sold
Item A. Complete Item O.)
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. TAXPAYER TYPE
Individual Owner
Co-Ownership
General Partnership
(Select only one
(C, D1, D4, E, F, I-K, N-S)
(C, D2, D4, E, F, I-K, N-S)
(C, D3, D4, E, G, I-K, N-S)
type then proceed
to Item C.)
Corporation
Limited Liability Company (LLC)
Other (Specify)
(C, D4, E, G-S)
(C, D4, E, G-S)
C. 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)
D. EMPLOYEE
“Employment” does not include service performed by a child under the age of 18 years in the employ of his/her father or
mother, or service performed by an individual in the employ of his/her son, daughter, or spouse, including the employee’s
INFORMATION
registered domestic partner. (Section 631 of the
California Unemployment Insurance
Code) Refer to Information Sheet:
Family Employment
(DE
231FAM) at
D1. INDIVIDUAL
Do you only employ your spouse, parent(s), or minor child(ren) (under 18)? If yes, you are not subject to
Yes
No
OWNER (Only)
Unemployment Insurance (UI) and State Disability Insurance (SDI) but may be subject to Personal Income Tax (PIT).
D2. CO-OWNERSHIP
Do you only employ your minor child(ren) (under 18)? If yes, you are not subject to UI and SDI but may
Yes
No
(Only)
be subject to PIT.
D3. PARTNERSHIP
Do you only employ your parent(s)? If yes, you are not subject to UI and SDI but may be subject to PIT.
Yes
No
(Consisting of
siblings only.)
D4. DO YOU EMPLOY
If yes, please enter:
Yes
No
EDD Account Number: _____-______-__ Business Name:___________________________________
NONAGRICULTURAL
WORKERS?
DE 1AG Rev. 12 (2-16) (INTERNET)
Page 1 of 4
CU
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