Mesa Shedule B - Successorship Questionnaire

ADVERTISEMENT

Michigan Employment Security Agency
518 Schedule B (Rev. 9/97). Formerly MESA 1009-B.
MESA SCHEDULE B - SUCCESSORSHIP QUESTIONNAIRE
Issued under authority of the Michigan Employment Security Act of 1936. Filing is mandatory for successors.
Successorship Reporting Requirement. If you acquired any part of the Michigan assets, organization, trade or
business of another employer by purchase, rental, lease, inheritance, merger, foreclosure, gift or any other form
of transfer, you must provide the following information. If you made multiple acquisitions, you must file a
separate Schedule B for each acquisition.
MESA Account Number, if already assigned
Federal Employer Identification Number (FEIN, required)
1. Former Owner Information.
B.
A.
Former Owner's Name
Area Code & Telephone Number
Corporate Name or DBA
Former Owner's MESA No. or FEIN, if known.
C.
Current Street Address (not a P.O. Box)
City, State, ZIP
2. Acquisition Information.
Date Acquired
What
Did you acquire all, part or none of the former
A.
percent?
%
All
Part
None
owner's assets?
Did you acquire all, part or none of the former
B.
All
Part
None
owner's organization (employee, payroll/personnel)
Did you acquire all, part or none of the former
C.
All
Part
None
owner's Michigan trade (customers/accounts)?
Did you acquire all, part or none of the former
D.
All
Part
None
owner's Michigan business (products/services)?
If no, enter date closed by former owner.
E.
Was the Michigan business being operated at the
Yes
No
month
day
year
time of acquisition?
Yes
No
F.
Are you conducting the Michigan business
you acquired?
Is your Michigan business substantially owned or
G.
Yes
No
controlled in any way by the same interests that
owned or controlled the former business?
H.
Did you hold any secured interest in any of the
Yes
No. If yes, enter the balance owed $_______________.
Michigan assets acquired?
I.
What was the reasonable value of the Michigan
$____________________.
organization, trade, business or assets acquired?
Attach this schedule to your Registration for Michigan Taxes and mail it to the Michigan
Department of Treasury. Your signature on that document is binding for all schedules.
9

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go