Ncui 604 Form – Fill Out and Use This PDF

The NCUI 604 form is an Employer Status Report utilized by the North Carolina Department of Commerce, Division of Employment Security, to assess an employing unit's liability under the North Carolina Employment Security Law, General Statute 96, and Division Regulations. This form requires detailed information about the business such as federal and state tax identification numbers, employment details, and ownership type. For detailed guidance on completing this form and to determine your business' obligations under the law, click the button below.

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Ncui 604 Form PDF Details

The NCUI 604 form plays a crucial role for businesses operating within North Carolina, serving as a bridge to compliance with the state's Employment Security Law and applicable Division Regulations. Recognized formally as the Employer Status Report, it must be submitted by every employing entity to the North Carolina Department of Commerce's Division of Employment Security. This document's purpose is multifold: it establishes whether an entity meets the criteria for unemployment tax liability, guides through the categorization process of businesses based on their workforce and payroll sizes, and collects essential data on the employer, including federal and state ID numbers, contact information, the type of business ownership, and detailed descriptions of business activities in North Carolina. Additionally, it addresses situations like changes in business ownership, mergers, or asset transfers, ensuring that employment security records accurately reflect the current structure and status of businesses. Critical for maintaining accurate employer records and determining liability, this form acts as a foundational document for businesses to align with state legal requirements, and with a mandate to return it within 10 days of receipt, timeliness in its completion is equally paramount.

Question	Answer
Form Name	Ncui 604 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	ncui 604 online, ncui604, amazon, form ncui 604

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THIS REPORT IS REQUIRED OF EVERY EMPLOYING UNIT AND WILL BE USED TO DETERMINE LIABILITY UNDER

THE NORTH CAROLINA EMPLOYMENT SECURITY LAW, GENERAL STATUTE 96 AND DIVISION REGULATIONS.

Employer Status Report

Please Read Instructions!

NC Dept. of Commerce

Division of Employment Security

Post Office Box 26504

Raleigh, N.C. 27611-6504

Please Type or Print in Black Ink or File Online www.ncesc.com

Return Within 10 Days

For Agency Use Only:

Account No.

Liable

A/C/AS

Y N

Root

OW/OF

S Add

ET AL

S/PR

Liab Date

Del After

Law Sec

M/W

County

ERA

Own

Curr

Orig

Ind Ctr

React Date

L Let

St Adj

PC Let

Federal ID number:__________________

2. N.C. Dept. of Revenue withholding ID number:

3.Enter any previously assigned North Carolina unemployment tax numbers:

4.Employer name:

Enter exact name of legal entity – for further details see instructions)

5.Trade name:

6.Mailing address:

	Street or P.O. Box		City	State	Zip Code
7.	Phone number: (_______)_____________________________	8.	FAX number: (_______)
9.	Contact person: ________________________________________________		Title
	Phone number: ( ______ )________________________ E-mail Address:
10.	N.C. business location:			Number of Employees expected

Street (Do not use a post office box)			in the next 12 months:
	N.C.
	N.C.
City		Zip Code		County
City		Zip Code		County

(Attach a list of ALL NC locations, if there is no NC business location, enter the primary employee’s home address)

11. Check type of ownership:	Individual	Sub-Chapter S Corporation
	General Partnership	501(c)(3) - Attach a copy
	Corporation	Governmental
	Limited Partnership - Attach a list of ALL General
	Partners

12.Enter the principal activity or services performed in your North Carolina operation:

LLC taxed as Individual LLC taxed as Partnership LLC taxed as Corporation

Indian Tribal Governments/Enterprises Disregarded Entity

Other:

13.If you are part of a larger organization and are primarily engaged in providing support services to that organization, check one of the following:

Control, Administrative (Headquarters, etc.)	Storage/Warehouse
Research, Development or Testing	Other

14.Enter date you first employed one or more workers in North Carolina: _________/________/___________

MM DD YYYY

For Items 15 through 20, check only the ONE item that applies

15. GENERAL EMPLOYERS:
a. Have you or will you have a quarterly payroll of $1,500 or more?	Yes
If yes, enter the date this occurred or will occur.

b. Have you or will you employ at least one worker in 20 different calendar weeks during a

calendar year?
If yes, enter the date this first occurred or will occur.	Yes

No	_____/_______/_______
	MM	DD	YYYY
No	_____/_______/_______
	MM	DD	YYYY

16. Are you an EMPLOYEE LEASING company?

Yes

17.AGRICULTURAL EMPLOYERS:

a. Have you or will you have a quarterly payroll of $20,000 or more?

If yes, enter the date this occurred or will occur

Yes

b. Have you or will you employ at least 10 workers in 20 different calendar weeks during a

calendar year?
If yes, enter the date this first occurred or will occur.	Yes

No
No	_____/_______/_______
	MM	DD	YYYY
No	_____/_______/_______
	MM	DD	YYYY

NCUI 604 (Rev 01/2012)

OVER PLEASE

18.DOMESTIC EMPLOYERS:

Have you or will you pay $1,000 or more in a calendar quarter for domestic service in a private home, college club, fraternity or sorority? If yes, enter the date this occurred or will occur.

Yes

No ______ /______/ _______

MM DD YYYY

19.NON-PROFIT ORGANIZATIONS: (Attach a copy of Federal Letter of Exemption under Section 501(c)(3) of the Internal

Revenue Code.)
Have you or will you employ four or more workers in 20 different calendar weeks
during a calendar year? If yes, enter the date this occurred or will occur.	Yes	No ______ /______/ _______
		MM	DD	YYYY

20.GOVERNMENTAL ENTITY: (check one type below)

Federal

State

Local

Other: ________________________________________

21.If you are not otherwise subject to the unemployment tax law under one of the preceding criteria (Items 15- 20), do you wish to voluntarily cover your employees for unemployment insurance?

22.Have you ever paid Federal Unemployment Tax (FUTA)?

If yes, for what year(s)?

________

Yes

23.If you have acquired, transferred assets or merged with another business, or made any other changes in the ownership of the business, including changes, such as from a sole proprietorship to a corporation or a partnership, complete the following:

a.Name of Former Owner: _____________________________________________________________________________

(Full Organizational Name, including Trade Name)

b.Former Owner’s N.C. UI Tax Number: _______________________________________

c. Former Owner’s Address: ________________________________________	__________________	__ __	__________
Street or P.O. Box	City	State	Zip Code
Street or P.O. Box

d. On what date did you acquire or change the business?	______ /______/ _______
	MM	DD YYYY

e.Did you acquire all or a portion of the former owner’s North Carolina business?

All

Portion (Specify) %______

f.Was the business in operation at the time you acquired it?

Yes

No Date Closed	______ /______/ _______
	MM	DD YYYY

g. Was the business in bankruptcy at the time you acquired it?

Yes

h.Does the former owner continue to have employees in North Carolina?

Yes

24.Do you have workers who perform services for your business whom you consider to be self-employed or independent contractors? If yes, see instructions for list to be attached.

Yes

25.List owners (parent corporation, sole proprietor, ALL general partners, principal corporate officers, or members.) Attach a list of those for which there is no space below.

______________________	______________________	_______________________		____________	_____________________
First Name	Middle Name	Last Name		Title	SSN or FEIN
_________________________________________		_______________________	__ __	___________	(____) ____ ______
Street or P.O. Box		City	State	Zip Code	Phone
______________________	______________________	_______________________		____________	_____________________
First Name	Middle Name	Last Name		Title	SSN or FEIN
_________________________________________		_______________________	__ __	__________	(____) ____ ______
Street or P.O. Box		City	State	Zip Code	Phone
______________________	______________________	_______________________		____________	_____________________
First Name	Middle Name	Last Name		Title	SSN or FEIN
_________________________________________		_______________________	__ __	__________	(____) ____ ______
Street or P.O. Box		City	State	Zip Code	Phone

Be Sure That All Applicable Items Are Completed Before Signing

I certify that the information entered on this form is true and accurate, and that I am authorized by the named employing unit to complete this report for determining unemployment tax liability.

_____________________________________________	___________________________________	______ /______/ ________
Signature	Title	MM	DD	YYYY

NCUI 604 (Rev 02/2012)

How to Edit Ncui 604 Form Online for Free

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It's an easy task to fill out the form with our practical tutorial! Here is what you have to do:

1. Begin filling out the ncui604 with a selection of major blank fields. Collect all the information you need and be sure not a single thing omitted!

2. Your next step is to submit these blanks: Check type of ownership, County Attach a list of ALL NC, Individual General Partnership, SubChapter S Corporation c Attach, LLC taxed as Individual LLC taxed, Enter the principal activity or, If you are part of a larger, Control Administrative, Enter date you first employed one, StorageWarehouse Other, YYYY For Items through check, GENERAL EMPLOYERS, a Have you or will you have a, If yes enter the date this, and Yes.

Part number 2 for filling out ncui 604 online

3. The next part is going to be straightforward - fill in all of the empty fields in calendar year If yes enter the, Yes, MM DD YYYY, NCUI Rev, and OVER PLEASE to complete this process.

How to complete ncui 604 online portion 3

4. It's time to complete the next section! In this case you will have these DOMESTIC EMPLOYERS, Have you or will you pay or more, Yes, MM DD YYYY, NONPROFIT ORGANIZATIONS Attach a, Revenue Code Have you or will you, Yes, MM DD YYYY, GOVERNMENTAL ENTITY check one, Federal, State, Other, If you are not otherwise subject, Have you ever paid Federal, and If yes for what years blanks to complete.

Filling out segment 4 of ncui 604 online

5. And finally, the following last subsection is what you need to wrap up before using the form. The blank fields in question include the following: e Did you acquire all or a portion, f Was the business in operation at, Yes, No Date Closed, g Was the business in bankruptcy, Yes, All, Portion Specify, MM DD YYYY, h Does the former owner continue, Yes, Do you have workers who perform, independent contractors If yes see, Yes, and List owners parent corporation.

Guidelines on how to fill in ncui 604 online portion 5

Be very attentive when filling in independent contractors If yes see and All, since this is the section where most people make errors.

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Ncui 604 Form – Fill Out and Use This PDF

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