In the dynamic landscape of Ohio's business and labor law, the Ohio Unemployment Compensation Act 3 (UA-3) form sits at a crucial intersection of employment relations and regulatory compliance. This relatively straightforward yet pivotal document serves as a critical notification mechanism for the Bureau of Workers' Compensation (BWC). It ensures the BWC is promptly informed about the nuances of relationships between Professional Employer Organizations (PEOs) and their clients. Specifically, it addresses the commencement of a new client relationship, changes in the nature of existing relationships, or the termination of such partnerships. Required to be sent either via postal service to the designated BWC office or through fax, this form plays an essential role in maintaining transparent and compliant operations within Ohio's employment framework. Crucially, the UA-3 form adheres to strict deadlines—new contracts must be reported within 30 days of their start, and terminations within 14 days. Failure to meet these deadlines results in the BWC recognizing the received date of the UA-3 form as the official date of the contract changes. Furthermore, the form captures detailed information about both the PEO and the client, including policy numbers, company names, and specific details regarding the lease or termination of employee services. The detailed reporting requirements, including classifications for payroll and claims, underscore the importance of accuracy and thoroughness in fulfilling Ohio's regulatory demands. Signatures from both parties at the end of the document attest to the validity of the information, reminding that any omission or intentional misrepresentation carries serious legal consequences. This documentation process underscores the commitment of Ohio's legal system to safeguard rights, ensure employer accountability, and foster a stable employment environment.
| Question | Answer |
|---|---|
| Form Name | Ohio Form Ua 3 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | what is a ua3 form for oh, accrual, 22nd, PEO |
Professional Employer Organization
Client Relationship Notification
Instructions
∙Use this form to notify BWC of a new client, change of relationship with a current client or termination of a client.
∙Mail this form to BWC, PEO Unit, 22nd Floor, 30 W. Spring St., Columbus, OH
∙BWC must receive new contract notification within 30 days of the effective date of the contract. BWC must receive contract termination notifications within 14 days of the effective date of the termination.
∙Notice: Pursuant to Ohio Administrative Code
Professional employer organization (PEO) information
Company name |
Policy number |
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Contact person name |
Telephone number |
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PEO lease information
Check only one |
Change existing policy number reporting client |
Effective date of lease, termination or change in |
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New lease |
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payroll/claims |
Ohio |
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Lease termination |
Change to portion of client’s employees assumed by PEO |
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(No splitting of employees within a manual classification) |
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Client company information
Client company name |
Client policy number |
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DBA |
Federal ID number |
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Mailing address (P.O. Box if applicable) |
Client phone number |
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City |
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Employee reporting (payroll and claims) |
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List class codes reportable by PEO |
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List class codes reportable by client |
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All under the PEO policy |
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PEO |
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Client |
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All under the client policy |
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A portion under the PEO policy |
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(Partial wages reported to BWC under the |
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client policy must be reported under the |
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FEIN of the client employer) |
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Signatures are required by both parties
Title
Date
Print client signatory
Client signature
Print PEO signatory
PEO signature
Note: Signing this form is an acknowledgement that all the information listed on this form is complete and true to the best of your knowledge. Omission of any of the items required or intentional misrepresentation of any of the above information on this form may lead to registration revocation as outlined in Ohio Revised Code Section 4125.