Dws Ark 201 Form PDF Details

When navigating the complexities of employment and business operations in Arkansas, understanding and accurately completing the DWS-ARK-201 form is crucial. This form serves as a Status Report to Determine Liability Under The Department of Workforce Services Law, which is essential for any business with employees operating within the state. It touches on several key areas that employers must report on, including the type of ownership, employer identification numbers, and detailed information regarding the ownership and operational addresses. Moreover, it requires detailed listings of officers or owners, the nature of the business, employment specifics (both domestic and agricultural, if applicable), and any changes in ownership or corporate name. The form also provides a section for businesses to describe the nature of their operation in Arkansas, ensuring that the Department of Workforce Services accurately understands the scope of their activities. Whether a business is just starting out or has been in operation for a while, completing this form accurately plays a vital role in compliance with state labor laws, impacting how businesses handle their reporting and contributions to the state's unemployment insurance program. This document is not just a formality; it's a critical step in establishing a business's responsibilities and rights under Arkansas law.

QuestionAnswer
Form NameDws Ark 201 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesezarc adws arkansas gov, arkansas department of workforce services, arkansas department of workforce services forms, dws arkansas gov

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Department of

P.O. Box 8007

WORKFORCESERVICES

Little Rock, AR 72203-8007

Telephone (501) 682-3798

STATUS REPORT

Report To Determine Liability Under The Department of Workforce Services Law

IDENTIFICATION SECTION

1. ACCOUNT NUMBER ASSIGNED BY DWS (IF ANY)

2. FEDERAL EMPLOYER I.D. NUMBER

3. TYPE OF OWNERSHIP (CHECK ONE)

 

 

1.

o Corporation

1a.o LLC

2.

 

 

 

 

3.

o Individual (Sole Proprietor)

4.

o Professional Association

5.

o Limited Partnership

6. o Estate

7.

8.

Political Subdivision

9.

Trust

10.o Leasing (PEO)

 

 

o

o

Partnership

State Agency

IF THE TYPE OF BUSINESS IS A CORPORATION/LLC ENTER THE CORPORATE NAME IN ITEM 4 BELOW.

4. NAME

5. MAILING ADDRESS

 

 

CITY

STATE

ZIP CODE

PHONE NUMBER

()

6. ENTER THE NAME (OR FIRM NAME) AND BUSINESS ADDRESS WHERE PAYROLL RECORDS ARE KEPT (IF DIFFERENT FROM ITEM #5).

NAME

MAILING ADDRESS

 

 

CITY

STATE

ZIP CODE

PHONE NUMBER

()

If the type of ownership is an individual or partnership, enter the name(s) and social security number(s) as applicable below, or if the type of ownership is a corporation/LLC, complete the information for two oficers. Do not list Board Members or Directors.

7. Owners Or

NAME

SOCIAL SECURITY NUMBER

TITLE

RESIDENCE ADDRESS, CITY, STATE, ZIP

 

Corporate

 

 

 

 

 

 

 

Oficers

 

 

 

 

 

 

 

Attach

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional

 

 

 

 

 

 

 

Sheet If

 

 

 

 

 

 

 

Necessary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Business

TRADE NAME

 

STREET ADDRESS, CITY, ZIP, COUNTY

TELEPHONE NO.

No. of Employees

PHYSICAL

 

 

 

 

 

 

 

LOCATION

 

 

 

 

 

 

 

In Arkansas

 

 

 

 

 

 

 

REQUIRED

 

 

 

 

 

 

 

Attach

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional

 

 

 

 

 

 

 

Sheet If

 

 

 

 

 

 

 

Necessary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.IF YOUR BUSINESS

IS A CORPORATION/ LLC, ENTER: ▲ ▲

10.

IF THE BUSINESS IN ARKANSAS WAS ACQUIRED FROM ANOTHER LEGAL ENTITY

ENTER:

▲ ▲

 

ORIGINAL CORPORATE NAME, IF DIFFERENT THAN ABOVE

PREVIOUS OWNER’S ACCOUNT NUMBER (IF KNOWN)

 

 

 

MONTH

DAY

YEAR

 

 

 

DATE OF ACQUISITION:

▲ ▲

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PREVIOUS OWNER

 

ADDRESS

 

CITY

 

STATE

 

 

 

 

 

 

 

 

WHAT PORTION OF THIS

 

 

 

 

 

 

ACCOUNT WAS ACQUIRED? (CHECK (ONE) ALL.

 

PART(SPECIFY PERCENTAGE) _____________________

EMPLOYMENT SECTION

11.ENTER THE DATE YOU BECAME LIABLE FOR STATE UNEMPLOYMENT (HAD ONE OR MORE EMPLOYEES IN SOME PART OF TEN DAYS) (ACA 11-10-209)(1). SEE INSTRUCTIONS

11a. ENTER THE DATE YOU FIRST PAID WAGES IN ARKANSAS

12. IF YOUR ACCOUNT HAS

ENTER THE DATE YOUR ORGANIZATION RESUMED EMPLOYING

BEEN INACTIVE:

SOMEONE IN ARKANSAS.

 

 

MONTH

DAY

YEAR

▲ ▲ ▲ ▲ ▲ ▲

13.IF YOU ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE OF 1954 SECTION 501 (C)(3), ATTACH

A COPY OF YOUR EXEMPTION LETTER. INDICATE YOUR PREFERENCE: o REIMBURSE o CONTRIBUTORY

DOMESTIC - HOUSEHOLD EMPLOYMENT SECTION

Complete 14 only if you have domestic or household employees(Includes maids, cooks, chauffeurs, sitters, etc.)

14.ENTER THE ENDING DATE OF THE FIRST CALENDAR QUARTER IN WHICH YOU PAID GROSS WAGES

OF $1,000 OR MORE TO EMPLOYEES PERFORMING DOMESTIC SERVICE:▲ ▲

MONTH DAY

YEAR

REPORTING SECTION

DWS ENCOURAGES ALL EMPLOYERS TO REGISTER AND FILE ONLINE AT: www.ar-tax.org

DWS-ARK-201 (Rev. 01-07) PAGE 1 OF 2

(CONTINUED ON REVERSE SIDE)

AGRICULTURE EMPLOYMENT SECTION

15.

 

ARE YOU AN AGRICULTURAL EMPLOYER? (FARM OR RANCH)

YES

oNO

16. ENTER THE ENDING DATE OF THE TWENTIETH WEEK IN WHICH YOU HAD AT LEAST TEN EMPLOY- MONTH DAY

YEAR

EES IN ARKANSAS PERFORMING AGRICULTURAL LABOR:

▲ ▲

 

17.ENTER THE ENDING DATE OF THE FIRST CALENDAR QUARTER IN WHICH TOTAL WAGES OF

$20,000.00 OR MORE WERE PAID FOR AGRICULTURAL LABOR:▲ ▲

VOLUNTARY ELECTION SECTION

18. IF YOU ARE NOT LIABLE UNDER A COMPULSORY PROVISION OF THE DEPARTMENT OF WORKFORCE SERVICES LAW, AND

WISH TO VOLUNTARILY ELECT COVERAGE FOR YOUR EMPLOYEES; CHECK HERE ABILITY TO BEGIN: __________________________________

o, AND ENTER THE YEAR YOU WISH LI-

AT THE END OF TWO (2) YEARS FROM THIS DATE, OR AT THE END OF ANY SUBSEQUENT

CALENDAR YEAR, YOU MAY WITHDRAW THIS ELECTION BY FILING A WRITTEN REQUEST.

YOU WILL BE NOTIFIED OF THIS DETERMINATION IN WRITING.

NATURE OF BUSINESS SECTION

19.

DESCRIBE FULLY THE NATURE OF YOUR

BUSINESS IN ARKANSAS AND LIST THE

PRINCIPAL PRODUCTS IN ORDER OF IM-

PORTANCE:

▲ ▲

CODE SHORT TITLE

11Agricultural, Forestry, and Hunting

111- Crops Production

112- Animal Production

113- Forestry and Logging

114- Fish, Hunting, and Trapping

115- Support Services for Agriculture and Forestry

21Mining

211- Oil and Gas Extraction

212- Mining (except Oil and Gas)

22Utilities

221- Utilities

23Construction

236- Construction of Buildings

237- Heavy and Civil Engineering Construction

238- Specialty Trade Contractors

31-33 Manufacturing

311- Food Manufacturing

312- Beverage and Tobacco Product Manufacturing

313- Textile Mills

314- Textile Product Mills

315- Apparel Manufacturing

316- Leather and Allied Product Manufacturing

321- Wood Product Manufacturing

322- Paper Manufacturing

323- Printing and Related Support Activities

324- Petroleum and Coal Products Manufacturing

325- Chemical Manufacturing

326- Plastics and Rubber Products Manufacturing

327- Nonmetallic Mineral Product Manufacturing

331- Primary Metal Manufacturing

332- Fabricated Metal Product Manufacturing

333- Machinery Manufacturing

334- Computer and Electronic Product Manufacturing

335- Electrical Equipment, Appliance, and Component Manufacturing

336- Transportation Equipment Manufacturing

337- Furniture and Related Product Manufacturing

339- Miscellaneous Manufacturing

42Wholesale Trade

423- Merchant Wholesalers, Durable Goods

424- Merchant Wholesalers, Nondurable Goods

425- Wholesale Electronic Markets and Agents and Broker

44-45 Retail Trade

CODE

 

SHORT TITLE

CODE

SHORT TITLE

441

-

Motor Vechicle and Parts Dealers

533

- Lessors of Noninancial Intangible Assets

442

-

Furniture and Home Furnishings Stores

54 

(except Copyrighted Works)

443

-

Electronic and Appliance Stores

Professional, Scientiic, and Technical Services

444

-

Building Material and Garden Equipment and Supplies Dealers

541

- Professional, Scientiic, and Technical Services

445

-

Food and Beverage Stores

55 Management of Companies and Enterprises

446

-

Health and Personal Care Stores

551

- Management of Companies and Enterprises

447

-

Gasoline Stations

56 

Administrative and Support and Waste Management

448

-

Clothing and Clothing Accessories Stores

     

  and Remediation Services

451

-

Sporting Goods, Hobby, Book, and Music Stores

561

- Administrative Support Services

452

-

General Merchandise Stores

562

- Waste Management and Remediation Services

453

-

Miscellaneous Store Retailers

61 

Educational Services

454

-

Nonstore Retailers

611

- Educational Services

48-49

Transportation and Warehousing

62 Health Care and Social Assistance

481

-

Air Transportation

621

- Ambulatory Health Care Services

482

-

Rail Transportation

622

- Hospitals

483

-

Water Transportation

623

- Nursing and Residential Care Facilities

484

-

Truck Transportation

624 - Social Assistance

485

-

Transit and Ground Passenger Transportation

71 Arts, Entertainment, and Recreation

486

-

Pipeline Transportation

711

- Performing Arts, Spectator Sports, and Related Industries

487

-

Scenic and Sightseeing Transportation

712

- Museums, Historical Sites, and Similar Institutions

488

-

Support Activities for Transportation

713

- Amusement, Gambling, and Recreational Industries

491

-

Postal Service

72 

Accommodation and Food Services

492

-

Couriers and Messengers

721

- Accommodation

493

-

Warehousing and Storage

722

- Food Services and Drinking Places

51

Information

81 

Other Services (except Public Administration)

511 -

Publishing Industries (except internet)

811

- Repair and Maintenance

512 -

Motion Picture and Sound Recording Industries

812

- Personal and Laundry Services

515 -

Broadcasting (except internet)

813

- Religious, Grantmaking, Civic, Professional, and Similar

516 -

Internet Publishing and Broadcasting

 

Organizations

517 -

Telecommunications

814

- Private Household

518 -

Internet Service Providers, Web Search Portals, and Data

92 

Public Administration

 

 

Processing Services

921

- Executive, Legislative, and Other General Government Support

519 -

Other Information Services

922

- Justice, Public Order, and Safety Activities

52

Finance and Insurance

923

- Administration of Human Resource Programs

521 -

Monetary Authorities - Central Bank

924

- Administration of Environmental Quality Programs

522 -

Credit Intermediation and Related Activities

925

- Administration of Housing Programs, Urban Planning

523 -

Securities, Commodity Contracts, and Other Financial

 

and Community Development

 

 

Investments and Related Activities

926

- Administration of Economic Programs

524 -

Insurance Carriers and Related Activities

927

- Space Research and Technology

525 -

Funds, Trusts, and Other Financial Vehicles

928

- National Security and International Affairs

53Real Estate and Rental and Leasing

531- Real Estate

532- Rental and Leasing Services

AGENCY

USE

ONLY

NAICS CODE:

BLS OWN CODE:

AUX CODE:

COUNTY CODES:

STATUS BLS

SEASON CODE

Type Reimbursable _____

 

 

 

 

Origination Code _______

 

 

 

 

 

SIGNATURE SECTION

20.I HEREBY CERTIFY THAT THE PRECEDING INFORMATION IS TRUE AND CORRECT, AND THAT I AM AUTHORIZED TO EXECUTE

THIS STATUS REPORT ON BEHALF OF THE EMPLOYING UNIT NAMED HEREIN.

(AUTHORIZED SIGNATURES: OWNER, OFFICER, PARTNER OR AUTHORIZED AGENT PER POWER OF ATTORNEY. IF APPLI- CABLE, PLEASE ATTACH COPY OF POWER OF ATTORNEY.)

SIGNED BY:

TITLE:

CONTACT E-MAIL ADDRESS:

FAX NO.:

TELEPHONE:

DATE:

DWS-ARK-201 (Rev. 01-07) PAGE 2 OF 2

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Completing part 2 of arkansas workforce

3. This next step is focused on ARE YOU AN AGRICULTURAL EMPLOYER, AGRICULTURE EMPLOYMENT SECTION, EES IN ARKANSAS PERFORMING, ENTER THE ENDING DATE OF THE, OR MORE WERE PAID FOR, MONTH, DAY, YEAR, IF YOU ARE NOT LIABLE UNDER A, VOLUNTARY ELECTION SECTION, AT THE END OF TWO YEARS FROM THIS, YOU WILL BE NOTIFIED OF THIS, NATURE OF BUSINESS SECTION, DESCRIBE FULLY THE NATURE OF YOUR, and SHORT TITLE - type in each one of these blanks.

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