Form Rts-3 - Employer Account Change Form
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1Employer Account Change Form
RTS-3
R. 10/17
TC
If you need to report a change in legal entity or a change in ownership, you must submit a new
Rule 73B-10.037
Florida Business Tax Application (DR-1).
Florida Administrative Code
Effective Date 10/17
Section 1: Identify your tax account. To ensure changes are made to the correct account, please complete the
following information.
Account Name
(name of business or individual):
RT Account Number:
Mailing Address:
Business Partner Number:
City/State/ZIP:
Tax Certificate Number:
Email Address:
Federal Identification Number:
Telephone Number: (
)
Extension:
Fax Number: (
)
Section 2: Tax Type. This change applies to reemployment tax “RT” (formerly unemployment tax). However, if you wish to apply
this change to your other tax accounts, please check the applicable boxes below.
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q
q
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Corporate Income Tax
Gross Receipts Tax
Communications Services Tax
Sales and Use Tax
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q
q
q
Motor Fuels Tax
Documentary Stamp Tax
Solid Waste Fees and Surcharge
E-911 Tax
Section 3: Change your address. Select the address type and provide the new address information.
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q
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Business Location Address
RT Benefit/Claims Notice
RT Tax Rate Notice
Address Type:
(choose one or more)
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Mailing Address
Employer’s Quarterly Report
New Address Information
(name of business or individual):
Mailing Address:
City/State/ZIP:
Fax Number: (
)
Email Address:
Telephone Number: (
)
Extension:
Section 4: Change your account status. Request to inactivate, reactivate or cancel your account. Check the box next to the
appropriate action and provide the date this action becomes effective.
q
Inactivate – I have temporarily suspended business operations; I have no employees
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Action Requested (choose only one):
Reactivate – My business is now active; I am again paying wages
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Cancel – I have no plans for future business activity; cancellations can not be reversed
Effective date of action:
Section 5 : Corporate name change. I have changed my corporate name.
Corporate name changed to:
Effective date:
Section 6: Leasing Employees. I am leasing all or part of my employees.
Leasing Company’s
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Leasing all of my employees
RT Account Number:
Leasing Company’s
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Leasing part of my employees
Federal Identification Number:
Date I began leasing employees:
Leasing Company’s DBPR license number:
Section 7: Sign and date
I certify that I am legally authorized to make these changes with respect to the account number shown above.
Signature:
Date:
Title:
Telephone Number: (
)
Sign, date, and mail this Employer Account Change Form to:
Call 850-488-6800 for assistance.
Florida Department of Revenue
Information and forms are available on our website at:
P.O. Box 6510
or fax to:
Tallahassee FL 32314-6510
850-245-5896
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Parent category: Financial