This form contains 163 fields organized into 29 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Account Management
I WANT TO_Reopen#20a#20Previously#20Closed#20Account#20#28Provide#20the#20previous#20Employer#20Account#20Number#20at#20the#20top#20of#20Item#20A#20then#20go#20to#20Item#20B.#29 RadioButton
Select this option if you want to reopen a previously closed account. Provide the previous Employer Account Number at the top of Item A and then go to Item B.
I WANT TO_Close#20Employer#20Account#20#28Provide#20the#20Employer#20Account#20Number#20at#20the#20top#20of#20Item#20A.#29 RadioButton
Select this option if you want to close the employer account. Provide the Employer Account Number at the top of Item A.
Reason for Closing Account_No#20longer#20have#20employees RadioButton
Select this option if you are closing the account because you no longer have employees.
Reason for Closing Account_Out#20of#20Business RadioButton
Select this option if you are closing the account because the business is out of business.
Date of Last Payroll (mm) Text
Enter the month (mm) of the last payroll.
Max length: 2 characters
Business Information
LEGAL NAME OF ORGANIZATION (Corporation/LLC/LLP/LP: Enter exactly as it appears on your official registration documents.) Text
Enter the legal name of the organization exactly as it appears on your official registration documents. This is required for corporations, LLCs, LLPs, and LPs.
DOING BUSINESS AS (DBA) (If applicable) Text
Enter the Doing Business As (DBA) name if applicable.
FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) (9 digits) Text
Enter the Federal Employer Identification Number (FEIN). This should be a 9-digit number.
STATE OR PROVINCE OF INCORPORATION/ORGANIZATION Text
Enter the state or province where the business is incorporated or organized.
CALIFORNIA SECRETARY OF STATE ENTITY NUMBER (12 characters) Text
Enter the California Secretary of State Entity Number, which is a 12-character identifier for the business.
Max length: 12 characters
Business Sale
I WANT TO_Report#20a#20Sale#20of#20Business#20#28Provide#20the#20business'#20Employer#20Account#20Number#20at#20the#20top#20of#20Item#20A.#20Complete#20Item#20P.#29 RadioButton
Select this option if you want to report the sale of a business. Provide the business's Employer Account Number at the top of Item A and complete Item P.
Date of Sale (mm) Text
Enter the month (mm) when the sale of the business occurred.
Max length: 2 characters
Date of Sale (dd) Text
Enter the day (dd) when the sale of the business occurred.
Max length: 2 characters
Date of Sale (yyyy) Text
Enter the year (yyyy) when the sale of the business occurred.
Max length: 4 characters
Report a Sale of Business - Business Sold_Entire#20Business#20Sold RadioButton
Select this option if the entire business was sold.
Report a Sale of Business - Business Sold_Partial#20Business#20Sold RadioButton
Select this option if only a part of the business was sold.
Change Reporting
I WANT TO_Report#20a#20Change#20in#20Status:#20Business#20Ownership,#20Entity#20Type,#20or#20Name RadioButton
Select this option if you want to report a change in business ownership, entity type, or name.
Reason for Change Text
Provide the reason for the change you are reporting (e.g., new ownership, change in business name).
Change: From Text
Specify the previous information before the change (e.g., old business name or ownership details).
Change: To Text
Specify the new information after the change (e.g., new business name or ownership details).
Effective Date of Change (mm) Text
Enter the month of the effective date of the change in two digits (e.g., 07 for July).
Max length: 2 characters
Effective Date of Change (dd) Text
Enter the day of the effective date of the change in two digits (e.g., 15 for the 15th).
Max length: 2 characters
Effective Date of Change (yyyy) Text
Enter the year of the effective date of the change in four digits (e.g., 2023).
Max length: 4 characters
Contact Information
Check to allow e-mail contact CheckBox
Check this box to allow contact via e-mail.
E-MAIL - Valid E-mail Address Text
Enter a valid e-mail address for contact purposes.
Contact Person
CONTACT PERSON - Name Text
Enter the name of the contact person for this employer account.
CONTACT PERSON - Contact Phone Number Text
Enter the contact phone number of the contact person. The phone number should be up to 14 characters long.
Max length: 14 characters
CONTACT PERSON - E-mail Address Text
Enter the email address of the contact person.
CONTACT PERSON - Relation Text
Enter the relationship of the contact person to the business (e.g., owner, manager).
CONTACT PERSON - Address Text
Enter the address of the contact person.
Corporate Information
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (1)_Chg RadioButton
Select this option if you are changing the information of the first corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (1)_Del RadioButton
Select this option if you are deleting the information of the first corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (2)_Chg RadioButton
Select this option if you are changing the information of the second corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (2)_Del RadioButton
Select this option if you are deleting the information of the second corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (3)_Chg RadioButton
Select this option if you are changing the information of the third corporate officer, partner, LLC member, manager, or officer.
Date of Purchase
Date of Purchase (mm) Text
Enter the month (mm) when the business purchase occurred.
Max length: 2 characters
Date of Purchase (dd) Text
Enter the day (dd) when the business purchase occurred.
Max length: 2 characters
Date of Purchase (yyyy) Text
Enter the year (yyyy) when the business purchase occurred.
Max length: 4 characters
Declaration
DECLARATION - Signature date Text
Enter the date when the declaration was signed. The date should be in the format MM/DD/YYYY and up to 10 characters long.
Max length: 10 characters
DECLARATION - Name Text
Enter the name of the person making the declaration.
DECLARATION - Title Text
Enter the title of the person making the declaration. This could be a job title such as 'Manager' or 'Owner'.
DECLARATION - Phone Number Text
Enter the phone number of the person making the declaration. The phone number should be in the format (XXX) XXX-XXXX.
Max length: 14 characters
Effective Date of Update
Effective Date of Update(s) (mm) Text
Enter the month (mm) when the update(s) to the employer account information will take effect.
Max length: 2 characters
Effective Date of Update(s) (dd) Text
Enter the day (dd) when the update(s) to the employer account information will take effect.
Max length: 2 characters
Effective Date of Update(s) (yyyy) Text
Enter the year (yyyy) when the update(s) to the employer account information will take effect.
Max length: 4 characters
Employee Location
LOCATION OF EMPLOYEE SERVICES - Do you have employees working in California?_Yes RadioButton
Indicate whether you have employees working in California.
LOCATION OF EMPLOYEE SERVICES - Do you have employees working in California?_No RadioButton
Indicate whether you do not have employees working in California.
LOCATION OF EMPLOYEE SERVICES - Do you have employees residing in California that are working outside of California?_Yes RadioButton
Indicate whether you have employees residing in California that are working outside of California.
LOCATION OF EMPLOYEE SERVICES - Do you have employees residing in California that are working outside of California?_No RadioButton
Indicate whether you do not have employees residing in California that are working outside of California.
Employer Type
EMPLOYER TYPE_COMMERCIAL RadioButton
Select this option if the employer type is commercial.
EMPLOYER TYPE_PACIFIC#20MARITIME RadioButton
Select this option if the employer type is Pacific Maritime.
EMPLOYER TYPE_FISHING#20BOAT RadioButton
Select this option if the employer type is Fishing Boat.
Employment Details
PARTNERSHIP: Do you only employ your parent(s)? If yes, you are not subject to UI and SDI but may be subject to PIT_No RadioButton
Indicate whether you only employ your parent(s). If yes, you are not subject to Unemployment Insurance (UI) and State Disability Insurance (SDI) but may be subject to Personal Income Tax (PIT).
Existing Employer Account Number
Existing Employer Account Number (first digit of first 3 digits) Text
Enter the first digit of the first three digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (second digit of first 3 digits) Text
Enter the second digit of the first three digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (third digit of first 3 digits) Text
Enter the third digit of the first three digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (first digit of middle 4 digits) Text
Enter the first digit of the middle four digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (second digit of middle 4 digits) Text
Enter the second digit of the middle four digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (third digit of middle 4 digits) Text
Enter the third digit of the middle four digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (fourth digit of middle 4 digits) Text
Enter the fourth digit of the middle four digits of your existing employer account number.
Max length: 1 characters
Existing Employer Account Number (last digit) Text
Enter the last digit of your existing employer account number.
Max length: 1 characters
Form Actions
PRINT Button
Click this button to print the form.
Industry Activity
INDUSTRY ACTIVITY - Describe in detail your specific product/services Text
Provide a detailed description of the specific products or services your business offers.
INDUSTRY ACTIVITY - Select your business industry_Services RadioButton
Select this option if your business operates in the Services industry.
INDUSTRY ACTIVITY - Select your business industry_Retail RadioButton
Select this option if your business operates in the Retail industry.
INDUSTRY ACTIVITY - Select your business industry_Wholesale RadioButton
Select this option if your business operates in the Wholesale industry.
INDUSTRY ACTIVITY - Select your business industry_Manufacturing RadioButton
Select this option if your business operates in the Manufacturing industry.
INDUSTRY ACTIVITY - Select your business industry_Temporary#20Services RadioButton
Select this option if your business operates in the Temporary Services industry.
INDUSTRY ACTIVITY - Select your business industry_Leasing#20Employer RadioButton
Select this option if your business operates as a Leasing Employer.
INDUSTRY ACTIVITY - Select your business industry_Professional#20Employer#20Organization RadioButton
Select this option if your business operates as a Professional Employer Organization.
INDUSTRY ACTIVITY - Select your business industry_Other RadioButton
Select this option if your business operates in an industry not listed above.
INDUSTRY ACTIVITY - Specify other business industry Text
Specify the industry your business operates in if it is not listed in the options above.
Mailing Address
Same as above CheckBox
Check this box if the mailing address is the same as the physical business location.
MAILING ADDRESS - Street Number Text
Enter the street number of the mailing address.
MAILING ADDRESS - Street Name Text
Enter the street name of the mailing address.
MAILING ADDRESS - Unit Number (If applicable) Text
Enter the unit number of the mailing address, if applicable.
MAILING ADDRESS - City Text
Enter the city of the mailing address.
MAILING ADDRESS - State/Province Text
Enter the state or province of the mailing address.
MAILING ADDRESS - ZIP Code Text
Enter the ZIP code of the mailing address.
MAILING ADDRESS - Country Text
Enter the country of the mailing address.
MAILING ADDRESS - Phone Number Text
Enter the phone number for the mailing address. Maximum length is 14 characters.
Max length: 14 characters
Officer Information
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - NAME (1) Text
Enter the full name of the first corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - TITLE (1) Text
Enter the title or position of the first corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - SSN (9 digits) (1) Text
Enter the Social Security Number (SSN) of the first corporate officer, partner, LLC member, manager, or officer. The SSN should be 9 digits long.
Max length: 11 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - CA Driver License Number (1) Text
Enter the California Driver License Number of the first corporate officer, partner, LLC member, manager, or officer. The number should be up to 8 characters long.
Max length: 8 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (1)_Add RadioButton
Select this option if you want to add information for the first corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - NAME (2) Text
Enter the full name of the second corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - TITLE (2) Text
Enter the title or position of the second corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - SSN (9 digits) (2) Text
Enter the Social Security Number (SSN) of the second corporate officer, partner, LLC member, manager, or officer. The SSN should be 9 digits long.
Max length: 11 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - CA Driver License Number (2) Text
Enter the California Driver License Number of the second corporate officer, partner, LLC member, manager, or officer. The number should be up to 8 characters long.
Max length: 8 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (2)_Add RadioButton
Select this option if you want to add information for the second corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - NAME (3) Text
Enter the full name of the third corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - TITLE (3) Text
Enter the title or position of the third corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - SSN (9 digits) (3) Text
Enter the Social Security Number (SSN) of the corporate officer, partner, LLC member, manager, or officer. This should be a 9-digit number.
Max length: 11 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - CA Driver License Number (3) Text
Enter the California Driver License Number of the corporate officer, partner, LLC member, manager, or officer. This should be an 8-digit number.
Max length: 8 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (3)_Add RadioButton
Select this option if you want to add information for another corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - NAME (4) Text
Enter the full name of the corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - TITLE (4) Text
Enter the title of the corporate officer, partner, LLC member, manager, or officer (e.g., CEO, Manager).
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - SSN (9 digits) (4) Text
Enter the Social Security Number (SSN) of the corporate officer, partner, LLC member, manager, or officer. This should be a 9-digit number.
Max length: 11 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION - CA Driver License Number (4) Text
Enter the California Driver License Number of the corporate officer, partner, LLC member, manager, or officer. This should be an 8-digit number.
Max length: 8 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (4)_Add RadioButton
Select this option if you want to add information for another corporate officer, partner, LLC member, manager, or officer.
Owner Information
INDIVIDUAL OWNER/CO-OWNER INFORMATION - NAME (1) Text
Enter the name of the individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION - TITLE (1) Text
Enter the title of the individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION - SSN (9 digits) (1) Text
Enter the Social Security Number (SSN) of the individual owner or co-owner. The SSN should be 9 digits long.
Max length: 11 characters
INDIVIDUAL OWNER/CO-OWNER INFORMATION - CA Driver License Number (1) Text
Enter the California Driver License Number of the individual owner or co-owner. The number should be up to 8 characters long.
Max length: 8 characters
INDIVIDUAL OWNER/CO-OWNER INFORMATION (1)_Add RadioButton
Select this option to add information about the individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION - NAME (2) Text
Enter the name of the second individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION - TITLE (2) Text
Enter the title of the second individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION - SSN (9 digits) (2) Text
Enter the Social Security Number (SSN) of the second individual owner or co-owner. The SSN should be 9 digits long.
Max length: 11 characters
INDIVIDUAL OWNER/CO-OWNER INFORMATION - CA Driver License Number (2) Text
Enter the California Driver License Number of the second individual owner or co-owner. The number should be up to 8 characters long.
Max length: 8 characters
INDIVIDUAL OWNER/CO-OWNER INFORMATION (2)_Add RadioButton
Select this option to add information about the second individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION (1)_Chg RadioButton
Select this option if you are changing the information of the first individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION (1)_Del RadioButton
Select this option if you are deleting the information of the first individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION (2)_Chg RadioButton
Select this option if you are changing the information of the second individual owner or co-owner.
INDIVIDUAL OWNER/CO-OWNER INFORMATION (2)_Del RadioButton
Select this option if you are deleting the information of the second individual owner or co-owner.
Ownership Information
INDIVIDUAL OWNER - Do you only employ your spouse, parent(s), or minor child(ren) (under 18)? If yes, you are not subject to Unemployment Insurance (UI) and State Disability Insurance (SDI) but may be subject to Personal Income Tax (PIT)_Yes RadioButton
Select 'Yes' if you are an individual owner and only employ your spouse, parent(s), or minor child(ren) (under 18). Note: You are not subject to Unemployment Insurance (UI) and State Disability Insurance (SDI) but may be subject to Personal Income Tax (PIT).
INDIVIDUAL OWNER - Do you only employ your spouse, parent(s), or minor child(ren) (under 18)? If yes, you are not subject to Unemployment Insurance (UI) and State Disability Insurance (SDI) but may be subject to Personal Income Tax (PIT)_No RadioButton
Select 'No' if you are an individual owner and do not only employ your spouse, parent(s), or minor child(ren) (under 18).
CO-OWNERSHIP - Do you only employ your minor child(ren) (under 18)? If yes, you are not subject to UI and SDI but may be subject to PIT_Yes RadioButton
Select 'Yes' if you are a co-owner and only employ your minor child(ren) (under 18). Note: You are not subject to UI and SDI but may be subject to PIT.
CO-OWNERSHIP - Do you only employ your minor child(ren) (under 18)? If yes, you are not subject to UI and SDI but may be subject to PIT_No RadioButton
Select 'No' if you are a co-owner and do not only employ your minor child(ren) (under 18).
PARTNERSHIP: Do you only employ your parent(s)? If yes, you are not subject to UI and SDI but may be subject to PIT_Yes RadioButton
Select 'Yes' if you are in a partnership and only employ your parent(s). Note: You are not subject to UI and SDI but may be subject to PIT.
DATE OWNERSHIP BEGAN (MM) Text
Enter the month (MM) when the ownership of the business began.
Max length: 2 characters
DATE OWNERSHIP BEGAN (DD) Text
Enter the day (DD) when the ownership of the business began.
Max length: 2 characters
DATE OWNERSHIP BEGAN (YYYY) Text
Enter the year (YYYY) when the ownership of the business began.
Max length: 4 characters
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (3)_Del RadioButton
Indicate if you want to delete the information of the third corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (4)_Chg RadioButton
Indicate if you want to change the information of the fourth corporate officer, partner, LLC member, manager, or officer.
CORPORATE OFFICER(S), PARTNERS, OR LLC MEMBER(S), MANAGER(S), AND/OR OFFICER INFORMATION (4)_Del RadioButton
Indicate if you want to delete the information of the fourth corporate officer, partner, LLC member, manager, or officer.
Payroll Information
Date of Last Payroll (dd) Text
Enter the day of the last payroll in two digits (e.g., 05 for the 5th).
Max length: 2 characters
Date of Last Payroll (yyyy) Text
Enter the year of the last payroll in four digits (e.g., 2023).
Max length: 4 characters
First payroll date wages paid exceeded $100 (mm) Text
Enter the month (mm) when the first payroll date wages paid exceeded $100.
Max length: 2 characters
First payroll date wages paid exceeded $100 (dd) Text
Enter the day (dd) when the first payroll date wages paid exceeded $100.
Max length: 2 characters
First payroll date wages paid exceeded $100 (yyyy) Text
Enter the year (yyyy) when the first payroll date wages paid exceeded $100.
Max length: 4 characters
Physical Business Location
PHYSICAL BUSINESS LOCATION - Street Number Text
Enter the street number of the physical business location.
PHYSICAL BUSINESS LOCATION - Street Name Text
Enter the street name of the physical business location.
PHYSICAL BUSINESS LOCATION - Unit Number (If applicable) Text
Enter the unit number of the physical business location, if applicable.
PHYSICAL BUSINESS LOCATION - City Text
Enter the city of the physical business location.
PHYSICAL BUSINESS LOCATION - State/Province Text
Enter the state or province of the physical business location.
PHYSICAL BUSINESS LOCATION - ZIP Code Text
Enter the ZIP code of the physical business location.
PHYSICAL BUSINESS LOCATION - Country Text
Enter the country of the physical business location.
PHYSICAL BUSINESS LOCATION - Business Phone Number Text
Enter the business phone number for the physical business location. Maximum length is 14 characters.
Max length: 14 characters
Purchase Details
Purchase Price ($) Text
Enter the purchase price of the business in dollars ($).
Max length: 12 characters
Registration Options
I WANT TO_Register#20for#20a#20New#20Employer#20Account#20Number#20#28Go#20to#20Item#20B.#29 RadioButton
Select this option if you want to register for a new employer account number. If selected, proceed to Item B.
I WANT TO_Request#20Account#20for#20CalJOBS#20SM#20#28Service#20mark#29#20#28Go#20to#20Item#20B.#29 RadioButton
Select this option if you want to request an account for CalJOBS. If selected, proceed to Item B.
Report a Purchase of Business
I WANT TO_Report#20a#20Purchase#20of#20Business#20#28Provide#20the#20Seller's#20Employer#20Account#20Number#20at#20the#20top#20of#20Item#20A.#29 RadioButton
Select this option if you want to report the purchase of a business. Provide the seller's employer account number at the top of Item A.
Report a Purchase of Business - Business Purchase_Entire#20Business#20Purchase RadioButton
Select this option if the business purchase involves the entire business.
Report a Purchase of Business - Business Purchase_Partial#20Business#20Purchase RadioButton
Select this option if the business purchase involves only a part of the business.
Taxpayer Information
TAXPAYER TYPE_Other RadioButton
Select this option if the taxpayer type is 'Other'.
Specify other taxpayer type Text
Specify the type of taxpayer if 'Other' was selected.
Taxpayer Type
TAXPAYER TYPE_Individual#20Owner#20#28D,#20E1,#20F,#20G,#20J,#20K,#20L,#20O-T#29 RadioButton
Select this option if the taxpayer type is Individual Owner.
TAXPAYER TYPE_Limited#20Partnership#20#28D,#20F,#20H-T#29 RadioButton
Select this option if the taxpayer type is Limited Partnership.
TAXPAYER TYPE_Joint#20Venture#20#28D,#20F,#20H,#20I,#20K,#20L,#20O-T#29 RadioButton
Select this option if the taxpayer type is Joint Venture.
TAXPAYER TYPE_Co-Ownership#20#28D,#20E2,#20F,#20G,#20J,#20K,#20L,#20O-T#29 RadioButton
Select this option if the business is a Co-Ownership. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Association#20#28D,#20F,#20H-T#29 RadioButton
Select this option if the business is an Association. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Receivership#20#28D,#20F,#20H,#20K,#20L,#20O-T#29 RadioButton
Select this option if the business is under Receivership. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_General#20Partnership#20#28D,#20E3,#20F,#20H,#20J,#20K,#20L,#20O-T#29 RadioButton
Select this option if the business is a General Partnership. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Limited#20Liability#20Company#20#28LLC#29#20#28D,#20F,#20H-T#29 RadioButton
Select this option if the business is a Limited Liability Company (LLC). This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Estate#20Administration#20#28D,#20F,#20H,#20I,#20K,#20L,#20O-T#29 RadioButton
Select this option if the business is under Estate Administration. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Corporation#20#28D,#20F,#20H-T#29 RadioButton
Select this option if the business is a Corporation. This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Limited#20Liability#20Partnership#20#28LLP#29#20#28D,#20F,#20H-T#29 RadioButton
Select this option if the business is a Limited Liability Partnership (LLP). This field is used to specify the type of taxpayer for the employer account.
TAXPAYER TYPE_Trusteeship#20#28D,#20F,#20H,#20I,#20K,#20L,#20O-T#29 RadioButton
Select this option if the business is under Trusteeship. This field is used to specify the type of taxpayer for the employer account.
Update Employer Account Information
I WANT TO_Update#20Employer#20Account#20Information#20-#20Personal#20Name#20Change#20#28G#29 RadioButton
Select this option if you want to update the employer account information specifically for a personal name change.
I WANT TO_Update#20Employer#20Account#20Information#20-#20Add#2FChange#2FDelete#20Officer#2FPartner#2FMember#20#28H#29 RadioButton
Select this option if you want to update the employer account information to add, change, or delete an officer, partner, or member.
Update Options
I WANT TO_Update#20Employer#20Account#20Information#20-#20Address#20#28O,#20P#29 RadioButton
Select this option if you want to update your employer account information, specifically the address. Refer to sections O and P for details.
I WANT TO_Update#20Employer#20Account#20Information#20-#20Doing#20Business#20As#20#28D#20B#20A#29#20#28J#29 RadioButton
Select this option if you want to update your employer account information, specifically the Doing Business As (DBA) name. Refer to section J for details.