SR 2 Uc Sr2 Application
User Manual: SR-2
Open the PDF directly: View PDF 
.
Page Count: 2
| Download | |
| Open PDF In Browser | View PDF |
STATE OF ALABAMA DEPARTMENT OF LABOR UNEMPLOYMENT COMPENSATION DIVISION 649 MONROE STREET MONTGOMERY, ALABAMA 36131 STATUS UNIT: (334) 954-4730 FAX: (334) 954-4731 www.labor.alabama.gov APPLICATION TO DETERMINE LIABILITY IMPORTANT NOTICE Under Alabama law you are required to furnish the information requested on this application. Each false statement or refusal to furnish information on this report, or willful refusal to make contributions or other payments is punishable by fine or imprisonment, or both, and each day of such refusal shall constitute a separate offense. EMPLOYER NAME AND MAILING ADDRESS FEDERAL EMPLOYER I.D. NUMBER (FEIN) This number is assigned by the Internal Revenue Service 1. Mark (x) one type of employment. A separate form must be filed for each type of employment. NON-FARM AGRICULTURE DOMESTIC 2. Do you have a previous Alabama Unemployment Compensation Account? YES 3. Do you have employees located in another state? YES 4. Is your firm subject to the Federal Unemployment Tax Act (FUTA)? YES 4b. Have you remained liable since that date? YES 5. Did you start a new business? YES NO 5b. Date Alabama employment began: 6. If you acquired ALL or PART NO GOVERNMENT: NO STATE LOCAL 2a. If yes, account number: 3a. If yes, in what state(s)? NO 4a. If yes, year liability first incurred: NO 5a. If no, did you acquire an ongoing business? YES NO 5c. Date payroll began: of an ongoing business, enter the NAME,TRADE TITLE and ADDRESS of your predecessor employer: 6a. Predecessor's telephone number (if known): 6b. Predecessor FEIN (if known): 6c. If your predecessor was liable in Alabama, enter their Alabama Unemployment Account Number (if known): 6d. Date acquired from predecessor: 6e. Did your predecessor discontinue business? YES NO 6f. If yes, date discontinued: 7. List below TOTAL ALABAMA WAGES paid to all employees during each calendar quarter of each year from the date in Item 5b. Include remuneration paid to officers of corporations and wages of part-time employees for current year and previous year, if applicable. 8. List below, by type of employment, the number of individuals in your employ within each week. A month with five Saturdays is considered to have five weeks of employment. Include all part-time employees and officers remunerated by corporations. WEEK JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Current 1st Year 2nd 3rd 4th 5th Previous Year 1st 2nd 3rd 4th 5th FORM SR2 (Rev. 6-2012), CAT NO 53270 IMPORTANT: Please complete this application, Questions 1-14. PAGE 1 OF 2 9. ITEM 9 MUST BE COMPLETED IN ITS ENTIRETY. Use the enclosed instruction sheet for Item 9 to complete Columns 1-5; refer questions to LMI at 334-242-8873. Please Be Specific. List each location and type of operation or activity separately. (Attach additional sheets if necessary.) Column 1 Name Column 2 Location Alabama County Name and location -- Each unit in Alabama Enter "Statewide" if no permanent location Column 3 Column 4 Column 5 Employee count per unit Indicate specific type of activity in detail See Instructions Sheet for Assistance Enter Percent % % % % 9a. Is the above work site primarily engaged in performing support or services for other work sites of the company? YES 9b. To whom are most of your products sold? GENERAL PUBLIC WHOLESALERS OTHERS CONSTRUCTION CONTRACTORS NO RETAILERS (Specify) 10. Form of organization: INDIVIDUAL PARTNERSHIP NON-PROFIT ORGANIZATION (see 10b.) CORPORATION OTHER ASSOCIATION ESTATE OR TRUST LLC (see 10a.) (Specify) 10a. Indicate tax filing status with IRS (include all members and their social security numbers or Federal Identification numbers in Item 11) CORPORATION PARTNERSHIP SOLE PROPRIETOR DISREGARDED ENTITY YES 10b. Is the organization exempt under 501(c)(3) of the IRS Code? NO (If yes, submit a copy of the 501(c)(3) letter of exemption.) 11. For positive identification, list below the full name(s), social security number(s) and title(s) of individual owner, partners or officers. Name Social Security Number 12. If not otherwise subject, do you wish to voluntarily elect coverage under the Alabama Law? YES 13. Name and business location/physical address: Title NO 13a. Tax Preparer/CPA/Accountant: Name of Applicant, Employer, Corporation, Partnership, Trust, etc. Name of Tax Preparer/CPA/Accountant Trade Name or Division (if different from above) Trade Name or Division (if different from above) Physical Address Address City County Area Code – Telephone State Zip City Area Code – Facsimile County Area Code – Telephone Contact Person Contact Person Email Address Email Address State Area Code – Facsimile I certify the information provided on this application is true and correct to the best of my knowledge. 14. Business Name: Signature: Date: NOTE: IF CPA, TAX PREPARER, ETC., IS ONLY SIGNATURE, PLEASE ENCLOSE POWER OF ATTORNEY. FORM SR2 (Rev. 6-2012), CAT NO 53270 IMPORTANT: Please complete this application, Questions 1-14. Zip PAGE 2 OF 2
Source Exif Data:
File Type : PDF File Type Extension : pdf MIME Type : application/pdf PDF Version : 1.6 Linearized : Yes Author : Shannon Avant Create Date : 2016:02:11 10:44:47-06:00 Modify Date : 2018:02:12 08:27:48-06:00 Has XFA : No Tagged PDF : Yes XMP Toolkit : Adobe XMP Core 5.6-c015 84.159810, 2016/09/10-02:41:30 Metadata Date : 2018:02:12 08:27:48-06:00 Creator Tool : Acrobat PDFMaker 15 for Word Format : application/pdf Creator : Shannon Avant Document ID : uuid:37c11c66-92c9-4812-9512-fd58210fbbe6 Instance ID : uuid:52833c00-8d75-46ca-a916-7c6a107042cc Producer : Adobe PDF Library 15.0 State : 1 Version : 1.1 Page Count : 2EXIF Metadata provided by EXIF.tools