Form 150-211-156 - Business Change In Status Form
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Oregon Combined Payroll Tax
To update business status and employment information
Business Change in Status Form
Attach additional sheets if needed.
Business name
BIN (Oregon business identification number)
Owner/Officer updates:
To update owner/officer informa-
Other names (ABN/DBA)
FEIN (Federal employer identification number)
tion, attach a complete list of
current owners/officers including
position, social security number
(SSN), home address, and phone.
General updates
(check all that apply)
Update/Change FEIN to:
Update/Change business name to:
Now doing business in TriMet/Lane
Transit District as of:
Closing account
(check all that apply)
Closed pension/annuity account as of:
No longer doing business in TriMet/Lane Transit District as of:
All or
Part
of the business was
Closed
No longer doing business in Oregon
Sold
Leased
Transferred
Yes
No
Effective date:
Was business operating at the time it was sold, leased or transferred?
Date of final payroll:
How many employees were transferred?
Describe what was transferred
New business name
New owner’s name
New owner’s phone
New owner’s address
City
State
ZIP code
Where are the records of the terminated business? (Include contact name, phone, address, city, state, ZIP code)
Changing entity
(check all that apply)
Effective date:
Note: A new Combined Employer’s Registration form, 150-211-055, is required when there is an entity change.
Change
Corporation —“C”
Corporation—Subchapter “S”
LLP (Limited Liability Partnership)
from:
Individual (Sole Proprietor)
LLC (Limited Liability Company) Recognized by IRS as:
Partnership —General
Partnership—Limited
Corporation
Sole Proprietor/Single Member
Partnership
Change
Corporation —“C”
Corporation—Subchapter “S”
LLP (Limited Liability Partnership)
to:
Individual (Sole Proprietor)
LLC (Limited Liability Company) Recognized by IRS as:
Partnership —General
Partnership—Limited
Corporation
Sole Proprietor/Single Member
Partnership
Employment status updates
(check all that apply)
Still in business, but have no paid employees (corporate officers are still subject to payroll taxes). Effective date:
Only have workers’ compensation insurance
Only LLC members or officers
Only using independent contractors
to cover owners, officers or members.
Courtesy withholding
Employing Oregon residents in another state.
State:
Now working in Oregon.
Effective date:
Using leased employees
Name of leasing company
Worker leasing company license number
Date employees leased
Address
City
State
ZIP code
Leasing company contact name
Phone
Number of leased employees:
Number of non-leased employees:
Leasing corporate officers/owners?
Yes
No
Submitted by
Print name
Title
Signature
Date
Phone
Fax to: 503-947-1700
or mail to: Employment Department, 875 Union St NE Rm 107, Salem OR 97311-0030
150-211-156 (Rev. 12-16)
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Parent category: Financial