Form 309-6701 - Contractor Registration Application/renewal Form/form 60-0126 - Report To Determine Liability Page 4

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Step 2 of Contractor Registration Process:
Complete the Report to Determine Liability Form (attached)
You must complete and sign this form as part of your Contractor Registration Application. This Report to Determine Liability Form
helps us decide if you:
lNeed an unemployment insurance account, and
lNeed to pay unemployment insurance taxes.
You may be contacted by an unemployment insurance Field Auditor to verify information on the form. If you need an
unemployment insurance account, you will get an unemployment insurance account number in addition to your Contractor
Registration Number.
Sign and return the form with your Contractor Registration Application.
If you have questions about filling out the Report To Determine Liability, call:
l 800-562-4692 (outside Des Moines area)
l 515-281-5339 (Des Moines area)
l Your local Iowa Workforce Development Office and ask to speak to a Field Auditor.
l Auditors are available in:
m Burlington
(319) 753-1671, Ext. 31409
m Cedar Rapids
(319) 365-9474, Ext. 31108, 31125, 31133
m Council Bluffs
(712) 242-2120
m Davenport
(563) 445-3250 or 563-445-3252
m Des Moines
(515) 281-5339 or 800-562-4692
m Dubuque
(563) 556-5800, Ext. 125 or 126
m Ft. Dodge
(515) 576-0741, Ext. 3, 4, or 5
m Iowa City
(319) 351-4268, Ext. 31314 or 31315
m Marshalltown
(641) 844-6993
m Mason City
(641) 422-1520
m Ottumwa
(641) 684-5401, Ext. 104 or 107
m Spencer
(712) 262-1971, Ext. 129
m Sioux City
(712) 233-9032 or 712-233-9046
m Waterloo
(319) 235-2123, Ext. 320 or 319-235-9864

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