Indiana Form SF 2837 – Fill Out and Use This PDF

The Indiana SF 2837 form is an Application and Disclosure Statement used by the Indiana Department of Workforce Development for employer registration with the State Unemployment Tax Act (SUTA). This document mandates the disclosure of Social Security Numbers and requires accurate completion for the processing of employer registrations, with failure to do so potentially resulting in civil penalties. For those looking to navigate the intricacies of employer registration, understanding this form is imperative. Click the button below to begin the process of filling out your form promptly and accurately.

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Indiana Form SF 2837 PDF Details

The Indiana SF 2837 form is a comprehensive document necessary for businesses operating within the state to fulfill their obligations under the Unemployment Insurance system. Managed by the Indiana Department of Workforce Development (IDWD), this form plays a crucial role in the registration process for employer contributions towards unemployment benefits. It requires detailed disclosures, including the Federal Employer Identification Number (FEIN) or Social Security Number (SSN) for tax reporting, business identification information as recorded with the Indiana Secretary of State, and addresses for both physical operation and legal notices. Additionally, the form delineates various scenarios under which a business might qualify for different types of employment reporting, such as FUTA exempt organizations, domestic employment, agricultural employment, acquisition of an existing business, or starting as a new business with Indiana payroll liabilities. It further mandates the disclosure of any shared ownership, management, or control with current or former Indiana businesses, ensuring transparency and accuracy in the reporting and assessment of unemployment insurance contributions. Moreover, it emphasizes the need for the registration information to be certified as accurate by someone with sufficient authority in the organization, underlining the seriousness with which this documentation is treated to prevent fraud and ensure fairness in the unemployment insurance system.

Question	Answer
Form Name	Indiana Form SF 2837
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	in state form 2837, state form 2837 indiana, printable state form 2837, form 2837 indiana, suta account number application and disclosure statement

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Leave blank if not required to report.

SUTA ACCOUNT NUMBER APPLICATION & DISCLOSURE STATEMENT

State Form 2837 (R9 / 3-15)

INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT

10 N Senate Ave RM SE 202

Indianapolis, IN 46204‐2277

Confidential record pursuant To IC 4‐1‐16, IC 22‐4‐19‐6

* This agency is requesting disclosure of Social Security Numbers (SSNs) in accordance with IC 4‐1‐8‐1; disclosure is mandatory and this record cannot be processed without it.

IMPORTANT: Employer registration should be submitted on‐line at https://uplink.in.gov/ESS/ESSLogon.htm on or before the due date of the employer’s first quarterly report. If the employer is unable to submit an on‐line application and disclosure statement, a copy of this form, SF 2837, must be attached to the employer’s first quarterly contribution report (UC1S). Failure to timely register an account or to complete the application and disclosure statement accurately may result in civil penalties as described in IC 22‐4‐ 11.5‐9 being assessed to the Employer and / or to the non‐employer Agent. Please go to www.in . g ov / d w d / SUTA. htm for additional information or clarification.

SECTION ONE – IDENTIFICATION OF THE REGISTRANT

What is the FEIN number to be used by this business to issue the

IRS W2 or 1099 to workers or contractors?

What is the FEIN or SSN* to be used by this business to report business income to the IRS?

What is the complete, legal name of the business as registered with the Indiana Secretary of State?

Leave blank if not required to register. IDWD must be able to verify registration with the Indiana Secretary of State.

Date registered with the Indiana Secretary of State?

If not required to register with the Indiana Secretary of State, what is the legal name of the business used to secure the EIN from the IRS?

At what address will work be physically performed in Indiana? If registering for Tele‐work or similar activity, provide the worker’s address.

Do not use a PO Box. The state for this address defaults to Indiana. If no work is performed in Indiana, there is no Indiana SUTA liability.

Street

City

ZIP

‐

Complete SF48812, Indiana Business Location Report, for additional locations.

What is the address at which legal notices are to be served (mailing address for the business)?

Do not use a third party agent address.

Street

City

ZIP

‐

Canada

Mexico

What is the telephone number for the business? Do not use a third party agent phone number.

Telephone

‐

Ext or

Name

Fax

‐

State

Other

Please provide an email address where IDWD may contact a responsible party for the business. Leave blank if not applicable.

Page 1 of 4

SECTION TWO – QUALIFICATION OF THE ENTITY

You can only qualify – answer yes – to one qualification type (questions 1 – 6).

1. Are you registering as a FUTA exempt organization under 26 USC 3306(c)(7)			Yes
(government or municipality)?
If Yes, select the	Indiana State Agency	Federal Government
If Yes, select the	Indiana State Agency	Federal Government
type of entity:	Foreign/ International	Other State Agency
type of entity:	Foreign/ International	Other State Agency

(a)On what date was the first payroll check issued to an individual not excluded under IC 22‐4‐8‐2(i)(2):

No If No, go to questions 2.

Local Government

IN Quasi‐State Agency

If you answered Yes to Question 1, have selected the type of entity, and answered 1(a), go to section 3 to complete the registration. If you are electing to make payments in lieu of contributions, you must submit this form and SF 24321 within thirty‐one (31) days of the date indicated on 1(a).

2. Are you registering as a FUTA exempt organization under 26 USC 3306(c)(8) also			Yes
known as 501(c)(3)?
known as 501(c)(3)?

If Yes, are you an:	Indiana Not for Profit	Other State Not for Profit
(a) Are you a church or other non‐qualifying exempt organization requesting to				Yes
				Yes
voluntarily extend the Act?

No If No, go to question 3.

IMPORTANT: Voluntary election means that you are not required to pay into the unemployment system, but that you would like to pay contributions so that your workers are insured for unemployment. Voluntary election must be made by January 31st of the year for which is it effective and is binding for a minimum of two (2) calendar years. The election remains in effect unless terminated in writing after two (2) calendar years and by January 31st of the year of revocation. Checking Yes and signing this form is an election to extend the Act per IC 22‐4‐7 and IC 22‐4‐9. If you are making a voluntary election, please go to section 3 to complete the registration. An entity voluntarily electing to extend the act under IC 22‐4‐7‐2(d) is not eligible to make payments in lieu of contributions per IC 22‐4‐10‐1.

(b)Has your 501(c)(3) had four (4) or more workers in twenty (20) different calendar weeks in the same calendar year?

Yes

IMPORTANT: If you answered no to the above, and you are not voluntarily extending the Act, and you are not reporting a reorganization, spin‐off, or restructuring; you are not currently liable under IC 22‐4‐7‐2. Please submit this form only once you are liable. If you become liable at any time during a calendar year, you are liable for all payroll for the entire calendar year. A qualifying 501(c)(3) will always have a minimum of two (2) quarters to report at the time they become liable. If you are registering due to a reorganization, spin‐off, or restructuring of the organization, please go to question 5.

(c)Please provide the date on which you made your first payment to any worker:

(d)Please provide the date of the 20th calendar week when you had four (4) or more workers in the same year:

If you answered Yes to Question 2(b), have selected the type of entity, and have answered questions 2(c) and 2(d) please go to section 3 to complete the registration. If you are electing to make payments in lieu of contribution, you must submit this form and SF 24321 within thirty‐one (31) days of the date indicated on 2(d).

3.Are you registering to report domestic employment in a private home, local college club or local chapter of a college fraternity or sorority with wages of $1000 or more in a single calendar quarter?

Yes

No If No, go to question 4.

If Yes, select type of entity:		Home		LLC		Corporation

(a)On what date was the first payment made to a domestic worker:

(b)On what date did total payments to domestic workers for a quarter meet or exceed $1000:

Association

If you answered Yes to Question 3, have selected the type of entity, and have answered questions 3(a) and 3(b) please go to section 3 to complete the registration.

Page 2 of 4

4.Are you registering to report agricultural employment of $20,000 or more in a

single calendar quarter or of ten (10) workers in twenty (20) different weeks in the same calendar year? If you are reporting the reorganization, transfer or spin‐off of an agricultural operation, please go to question 5.

If Yes, select the	Proprietorship	Partnership


type of entity:	LLC	Other (specify)

Yes		No If No, go to
		question 5.

Corporation

(a)On what date was the first payment made to a worker:

(b)On what date did total payments to workers for a quarter meet or exceed $20,000? Leave 4(b) blank if not applicable:

(c)On what date did the 10th worker perform service in the 20th week of the year? Leave 4(c) blank if not applicable:

If you answered Yes to Question 4, have selected the type of entity, and have answered questions 4(a) and 4(b) or4(c) please go to section 3 to complete the registration.

5.Are you registering to report that you have acquired, through any means, all or part of the assets of an existing Indiana business entity?

Yes

No If No, go to questions 6.

IMPORTANT: Indiana requires that a business disclose the transfer of assets, including the workforce, between businesses. Answering no to this question indicates that you did not in any way assume operational control of all or part of an existing Indiana business including the workforce. Failure to disclose transfer of operational control of assets is considered a material misrepresentation under the Act. Please attach documentation which supports the type of transfer for evaluation under IC 22‐ 4‐10 and IC 22‐4‐11.5. For a bankruptcy, you must attach the specific Order approving the sale or transfer of the assets. If you disagree with the successorship determination of the Agency, you will have fifteen (15) days to protest the initial determination in writing per IC 22‐4‐32.

Select the type that best

describes this transfer:

Select the Acquirer

entity type:

Reorganization or FEIN Change Purchase/Transfer Franchise

Proprietorship

LLC

Bankruptcy

PEO/ Leasing Agreement

Partnership

Other (specify)

Sheriff’s Sale / Foreclosure Other purchase or transfer

Corporation

(a) To the best of your knowledge, what percent of the existing business transferred?

Please provide any known information regarding the identity of the Disposer:

FEIN

SUTA #

Name

(b) What day did operational control transfer to the acquirer?

Operational control transfers on the day that the acquirer has a legal right to direct the business operations, even if they do not immediately exercise the right.

If you answered Yes to Question 5, have selected the type of transfer, the type of entity, have answered questions 5(a) and 5(b), and have identified the disposer to the best of your ability, please go to section 3 to complete the registration.

6. Are you registering as a new business with liability for $1 or more in Indiana payroll?

If Yes, select the	Proprietorship	Partnership
type of entity:	LLC	Other (specify)
type of entity:	LLC	Other (specify)

(a) If yes, please provide the date of your first payroll payment:

	Yes		No
		Corporation


/			/
/			/

IMPORTANT: If you answered no to all questions, you have self evaluated as not being liable for Unemployment Insurance in Indiana at this time. Please submit this registration document only once your business has liability in Indiana for SUTA reporting and contribution

Page 3 of 4

SECTION THREE – DISCLOSURES AND CERTIFICATION OF INFORMATION

Provide the name of the person in this organization that should be notified in the event of an audit or investigation. Not a third party provider

First									Last
Name									Name

What is this person’s Social Security Number?* Mandatory disclosure

Does this business share ownership, management, or control with any current or former Indiana Business?

Yes

Please identify the related business:

SUTA #

FEIN

Name

IMPORTANT: If you have additional business relationships to disclose, please complete the related business disclosure form SF 28804.

What is the NAICS that best describes this entity? NAICS codes can be found at http://www.census.gov/eos/www/naics/

Code

Additional Keywords

Key Word(s) / Description

Provide the name and contact information for the person who prepared this form for signature.

First

Name

Telephone

‐

Last

Name

‐

Agent

Employee

Preparer’s Signature:		Date

Provide the name of the person who is the responsible party for registration of this entity. Do not identify a third party Agent.

First

Name

Telephone

‐

Last

Name

‐

Title

Responsible Party’s Signature:		Date

IMPORTANT: By signing this form, you are certifying that the information contained herein is true and accurate to the best of your knowledge and belief. You further affirm that you are a person of sufficient authority with regard to the named entity to file this document and to bind the business by the information provided including all required attachments and disclosures as indicated.

Third party providers: This form should not contain third party provider information for any required response except the preparer signature, if applicable. Employers can designate correspondence agents or external authorized users for Indiana SUTA purposes only via ESS as described in 646 IAC 5‐2‐15. Third party providers are hereby notified that submitting this form or any ESS registration where the agent self identifies as the responsible party for the employer is specifically prohibited and is a violation of the Act as described in IC 22‐4‐11.5‐9.

Mail completed forms to:	IDWD – Employer Status Reports	Fax: 317‐233‐2706
	10 N Senate Ave Rm SE 202	Questions: 800‐437‐9136 (2)
	Indianapolis, IN 46204‐2277	Handbook: www.in.gov/dwd

Page 4 of 4

How to Edit Indiana Form SF 2837 Online for Free

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It really is easy to fill out the form with this practical tutorial! Here's what you must do:

1. Start completing your in state form 2837 with a selection of major blanks. Consider all of the information you need and ensure nothing is overlooked!

state form 2837 conclusion process explained (portion 1)

2. Right after the prior part is filled out, go to enter the applicable details in these: At what address will work be, City, ZIP, Complete SF Indiana Business, What is the address at which legal, City, ZIP, State, Canada, Mexico, Other, What is the telephone number for, Telephone, Fax, and Ext or Name.

3. The next step is typically quite easy, You can only qualify answer yes, Are you registering as a FUTA, Yes, No If No go to questions Local, Indiana State Agency Foreign, If Yes select the Federal, Yes, Yes, Indiana Not for Profit, If No go to question, Other State Not for Profit, and Are you registering as a FUTA - every one of these blanks will have to be filled in here.

Yes, If No go to question, and Indiana Not for Profit inside state form 2837

4. The following subsection needs your details in the following areas: Are you registering as a FUTA, Yes, c Please provide the date on which, Are you registering to report, Yes, If No go to question, If Yes select type of entity, Home, LLC, Corporation, Association, a On what date was the first, and If you answered Yes to Question. Remember to fill in all needed info to go onward.

Be very mindful when completing Are you registering as a FUTA and LLC, because this is the part where many people make a few mistakes.

5. The document has to be finished by filling out this area. Further you can see a comprehensive list of blank fields that require specific information in order for your document submission to be faultless: Are you registering to report, Partnership Other specify, a On what date was the first, b On what date did total payments, Yes, If No go to question, Corporation, If you answered Yes to Question, Are you registering to report, Yes, If No go to questions, and IMPORTANT Indiana requires that a.

Step 3: Make certain your information is right and click on "Done" to progress further. Join FormsPal now and immediately gain access to in state form 2837, ready for download. Every change you make is handily kept , making it possible to customize the form at a later stage when required. We don't sell or share any details you provide while filling out forms at FormsPal.

Indiana Form SF 2837 – Fill Out and Use This PDF

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