Form Nys-100it - New York State Employer Registration For Unemployment Insurance, Withholding, And Wage Reporting For Indian Tribes
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1
2Department of Taxation and Finance and
NYS-100IT (02/13)
Department of Labor-Unemployment Insurance Div. Reg. Sec
State Office Campus, Bldg. 12
New York State Employer Registration
Albany, N.Y. 12240-0339
for Unemployment Insurance,
Withholding, and Wage Reporting for
┌
┐
Indian Tribes
For office use only:
U.I. Employer Registration No.
Return completed form (type or print in ink) to the
address above, or fax to (518) 485-8010
└
┘
Need Help? Call 1-888-899-8810
-
):
1. FEIN (Federal Employer Identification Number
(
)
-
2. Phone no.:
3. Legal name:
4. If your entity is not an Indian Tribe, are you a subdivision, subsidy, or enterprise wholly owned by the tribe?
Yes
No
5. Other commonly known name of entity:
6. Type of entity (e.g., housing authority, business, school, etc.:
7. Please check the option you wish to use to discharge your Unemployment Insurance liability:
Contribution method
Benefit reimbursement method
8. Enter the estimated or approximate number of individuals working in covered employment:
9. Enter the date covered employment began from 12/21/00 to the present:
(mmddyy)
Do not consider the following as covered employment:
● An elected official
● A person serving on a temporary basis in case of fire, storm,
● An member of a legislative body or of the judiciary body
snow, earthquake, flood or similar emergency
● A member of the state national guard or air national
● A person in a major nontenured policy making or advisory
guard, except a person who renders such services as a
position
● A person in a policy making or advisory position, the duties
regular state employee
● An inmate of a custodial or penal institution
of which ordinarily do not require more than eight hours per
week to perform
10. Enter the date of the first payroll from which you withheld or will withhold NYS Income Tax from your employees’ pay:
(mmddyy)
See next page
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