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Form Es-963a - Successor'S Application For Partial Transfer Of Predecessor'S Experience History Page 2

ES-963A (Rev. 5/98)

Page 2

NOTICE OF DETERMINATION BY THE NEW MEXICO DEPARTMENT OF LABOR

[ ]

Transfer of experience history from predecessor to successor account has been effected

as of

Successor tax rate for the calendar year(s) 19

[ ]

Transfer of experience history from predecessor to successor has not been effected

because:

( )

This Department has no evidence that the successor acquired a separate and

distinct employing enterprise from the predecessor.

( )

Wage

reports,

tax,

interest,

penalties

and/or

money

due

from

the

predecessor was not received by this Department either before or with the

application.

( )

This Department has no evidence showing the successor to have acquired an

employing enterprise.

( )

The successor failed to notify the Department of the acquisition, in

writing, not later than the due date of the successor's first quarterly

wage report.

( )

The successor's application does not contain the endorsement of the

predecessor.

( )

The required schedules of employment and wages did not accompany the

application.

( )

Schedules of employment and wages were not furnished for the 3 1/2 year

period preceding the date of computation or for such lesser period as the

enterprise(s) transferred may have been in operation.

( )

The application was not received within 30 days from the delivery or

mailing of such application by the Department to the successor's last known

address.

( )

The employment and wage schedules received do not agree with reports

previously received from the predecessor.

10.

( )

The application was not signed by the successor.

Successor tax rate for calendar year(s) 19

Effective Date

If either party to this determination does not believe it to be in accordance with the

Unemployment Compensation Law of New Mexico, he may request a review and redetermination by

the Chief of Tax Administration within fifteen (15) days following the date of mailing of this

determination.

A request for review should state with particularity wherein the party seeking

review feels the determination is in error and any additional facts or evidence the party

intends to raise in support of his request.

NEW MEXICO DEPARTMENT OF LABOR

Date of Determination

Title

Date of Mailing (If diff)

Form Es-963a - Successor'S Application For Partial Transfer Of Predecessor'S Experience History Page 2

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