Form Ador 74-4002 - Arizona Joint Tax Application Page 3
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4UNEMPLOYMENT TAX ADDENDUM
UC-001 A (3/03) - (Page 3)
I.
IF YOU ACQUIRED ALL OR PART OF AN EXISTING ARIZONA BUSINESS, PLEASE COMPLETE THIS SECTION
Date Acquired:
Acquired:
All
Part
Acquired by:
Purchase
Lease
Other
Explain Other:
II.
PREVIOUS OWNERS INFORMATION
Name(s) of Previous Owners:
Business Name of Previous Owners:
Current Street Address of Previous Owners:
City, State, ZIP
Current Telephone Number of Previous Owners:
Unemployment Number of Previous Owners:
III. VOLUNTARY ELECTION OF UNEMPLOYMENT TAX COVERAGE
The undersigned, on behalf of the employing unit, voluntarily elects beginning January 1 of the current calendar year or the date employment
started if later, and continuing for not less than two full calendar years to:
A. Become an employer subject to Title 23, Chapter 4, Arizona Revised Statutes, to the same extent as all other employers and extend
unemployment tax coverage to my employees although not mandatory.
B. Extend coverage to all employees performing services excluded from coverage as shown in Section VIII, on Page 2.
AGENCY USE ONLY
SIGNATURE/TITLE
DATE
APPROVED/DATE
ADDITIONAL INSTRUCTIONS FOR UNEMPLOYMENT TAX ADDENDUM
WHAT IS A SUCCESSOR EMPLOYER?
ACQUISITION OF A PART OF AN EXISTING ARIZONA
BUSINESS
When you acquire all or part of a business, which was required
to pay unemployment taxes in Arizona, you are a “successor” for
If you acquire a PART of a business and continue to operate it, you
unemployment tax purposes. As a successor, you are immediately
are not automatically assigned the tax rate and experience rating
liable for unemployment taxes regardless of the amount of wages
account of the former owner. To apply for a portion of the account
you pay or the number of workers you employ.
and its corresponding tax rate, you must fi le an “Application &
Agreement for Severable Portion Experience Rating Transfer”
As a successor, you may also take into account wages paid by
(UC-247) within 180 days of acquiring the business. The former
the former owner in determining the amount of wages on which
owner must agree and provide payroll information for the portions
you must pay taxes during the year in which you acquired the
of the business acquired and retained. Your account may then
business. For example, if the former owner has paid wages in
be charged for a portion of the unemployment benefi ts paid to
excess of $7,000 to a worker you continue to employ, you will not
the former owners’ employees. The application form is available
have to pay taxes on any additional wages you pay this worker in
online at or you may call (602) 248-9101
the year you acquire the business.
to obtain an application.
ACQUISITION OF ALL OF AN EXISTING ARIZONA
VOLUNTARY ELECTION OF UNEMPLOYMENT TAX
BUSINESS
COVERAGE
When you acquire an entire business and continue its operation,
Complete and sign this portion of the application ONLY if you
you are assigned the tax rate and experience rating account
wish to provide unemployment coverage to your employees,
of the former owner. The experience rating account includes
and you believe you are not REQUIRED to provide coverage.
the record of wages and taxes previously paid. Therefore, any
Refer to the “Employers Handbook” (available online at
unemployment benefi ts awarded based on wages paid by the
or “Guide to Arizona Employment Tax
former owner may be charged to your account. Additionally,
Requirements.”
you may be liable for taxes unpaid by the former owner. When
acquiring a business, consider whether any unemployment taxes
remain unpaid by the seller.
ADOR 74-4002 (3/03)
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