Fillable FEDERAL EMPLOYER I.D. NUMBER (FEIN) EMPLOYER NAME AND (State of Alabama)

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FEDERAL EMPLOYER I.D. NUMBER (FEIN) EMPLOYER NAME AND (State of Alabama)

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  • 44 check-boxes
  • 202 other fields

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File type: PDF

U.S.A. forms for State of Alabama

BROWSE STATE OF ALABAMA (AL) FORMS

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5c. Date payroll began:
of an ongoing business, enter the NAME,TRADE TITLE and ADDRESS of your predecessor employer:
STATE OF ALABAMA
DEPARTMENT OF LABOR
UNEMPLOYMENT COMPENSATION DIVISION
649 MONROE STREET
MONTGOMERY, ALABAMA 36131
STATUS UNIT: (334) 954-4730 FAX: (334) 954-4731
EMAIL: status@labor.alabama.gov
www.labor.alabama.gov
APPLICATION TO DETERMINE LIABILITY
I
MPORTANT NOTICE
Unde
r
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
GOVERNMENT: STATE
LOCAL
2. Do you have a previous Alabama Unemployment Compensation Account? YES NO 2a. If yes, account number:
3. Do you have employees located in another state? YES NO 3a. If yes, in what state(s)?
4. Is your firm subject to the Federal Unemployment Tax Act (FUTA)? YES NO 4a. If yes, year liability first incurred:
4b. Have you remained liable since that date? YES NO
5. Did you start a new business? YES NO 5a. If no, did you acquire an ongoing business? YES NO
5b. Date Alabama employment began:
6. If you acquired ALL or PART
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.
Current
Year
WEEK
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
1st
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
334-954-7447. Please Be Specific. List each location and type of operation or activity separately. (Attach additional sheets if necessary.)
N
ame Location
9a. Is the above work site primarily engaged in performing support or services for other work sites of the company? YES NO
9b. To whom are most of your products sold? GENERAL PUBLIC CONSTRUCTION CONTRACTORS RETAILERS
WHOLESALERS OTHERS (Specify)
10. Form of organization: INDIVIDUAL PARTNERSHIP CORPORATION ASSOCIATION ESTATE OR TRUST LLC (see 10a.)
NON-PROFIT ORGANIZATION (see 10b.) OTHER (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
10b. Is the organization exempt under 501(c)(3) of the IRS Code? YES 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
Title
12. If not otherwise subject, do you wish to voluntarily elect coverage under the Alabama Law? YES NO
13. Name and business location/physical address:
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 State Zip
City County State Zip
Area Code – Telephone Area Code – Facsimile
Area Code – Telephone Area Code – Facsimile
Contact Person
Contact Person
Email Address
Email Address
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. PAGE 2 OF 2
Column
1
Column
Column
Column
Column
2
3
4
5
Name and location -- Each unit in Alabama
Enter "Statewide" if no permanent location
Alabama
County
Employee
count per
unit
Indicate specific type of activity in detail
See Instructions Sheet for Assistance
Enter
Percent
%
%
%
%
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FEDERAL EMPLOYER I.D. NUMBER (FEIN) EMPLOYER NAME AND (State of Alabama)

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Completed 18 January 2022

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