Form Nys 100 New York State Employer Registration (Page 2 of 4) in pdf

Form Nys 100 New York State Employer Registration Page 2

Part D - Address/Telephone Information

Please enter your mailing and/or physical location address as well as the physical location of your books/records. If you wish to provide us

with additional addresses to direct specific forms, please indicate below.

(NOT

1. Mailing Address: This is YOUR business mailing address

Street or PO Box

your agent or paid preparer)

where all your Unemployment Insurance/

Withholding Tax mail will be directed unless otherwise indicated.

City

State

ZIP Code

(including

*If all your Unemployment Insurance/Withholding Tax mail

Forms NYS-45 and NYS-1)

is to be received at this mailing address,

do not complete sections 4 through 6.

Street

2. Physical Address: This is the ACTUAL location of your business

if different from the mailing address, or if your mailing address is a

P.O. Box. If you have more than one location, list your primary

City

State

ZIP Code

location.

c/o

3. Books/Records Address: This is the physical location where

your BOOKS/RECORDS can be found.

Street

Same as no. 1

Same as no. 2

Other - please complete

City

State

ZIP Code

ADDITIONAL ADDRESSES

c/o

(c/o):

4. Agent Address

This is the address of your AGENT, where

all your Unemployment Insurance mail will be directed unless other

addresses have been provided for the mailing of specific forms in

Street or PO Box

sections 5 and/or 6.

City

State

ZIP Code

(except quarterly return NYS-45 and

Note: All withholding tax mail

Return of Tax Withheld coupon NYS-1)

must be sent to your mailing

(no. 1).

Telephone

address

However, the quarterly return NYS-45 and coupon

NYS-1 may be directed to a separate address if no. 5 below is

(

)

completed.

c/o

Quarterly Combined Withholding, Wage Reporting and

(Form NYS-45)

Unemployment Insurance Return

and Return

of Tax Withheld (Form NYS-1) Address: If completed, this is the

Street or PO Box

address to which your NYS-45 and NYS-1 will be directed.

City

State

ZIP Code

Same as no. 4

Other - please complete

c/o

6. Notice of Entitlement and Potential Charges Address:

completed, this is the address to which the Notice of Entitlement

and Potential Charges will be mailed. This form is mailed each

Street or PO Box

time a former employee files a claim for Unemployment Insurance

benefits. Please attach a separate sheet if you need to indicate

City

State

ZIP Code

different Notice of Entitlement and Potential Charges addresses for

more than one physical location.

Part E - Business Information

(including partners of LLP or

Complete the following for sole proprietor, household employer of domestic services, all partners

RLLP),

(of LLC or PLLC),

all members

and all corporate officers , whether or not remuneration is received or services are performed in New

York State.

Name

Social Security No.

Title

Residence Address

(Continued on next page)

NYS-100 (10/02) (Page 2)

Form Nys 100 New York State Employer Registration Page 2

Related Articles

Related forms

Related Categories