Form UI-50A at a glance
What it is: Form UI-50A, Notice of Change: the employing unit gives notice of change(s) with respect to its business.
Who signs: This report must be signed by owner, partner, officer or authorized agent within the employing enterprise. If signed by any other person, a power of attorney must be on file. By signing you certify that the information and that contained in any attached sheets signed by you is true and correct.
A filled-in Form UI-50A example: a business reports a new name
How to fill out Form UI-50A, box by box
Employer Name, DBA Name, Account # and Address
Enter the Employer Name, DBA Name, Account #, Address and City, State, ZIP.
Enter the Date effective for the change(s) with respect to its business.
1. Name Change/Address Change/Miscellaneous Changes
Under 1. Name Change/Address Change/Miscellaneous Changes, if the name changed without change in legal entity, enter the New name.
If the Doing Business As name changed without change in legal entity, enter the New DBA name.
If the business address changed, enter the New address: Street, City, State, Zip.
If the telephone number changed, enter the New telephone number.
If the mailing address changed, enter Street, City, State, ZIP and Telephone Number. If you have multiple mailing addresses, complete UI-1M, Unemployment Insurance Special Mailing Form. If the Mailing Address is for an authorized representative, you must attach a Power of Attorney.
2. Request to Close Account
Enter A. Date you discontinued operations in Illinois, and Explain.
Enter B. Date you ceased employing workers, if you are still operating in Illinois, and Explain.
Enter C. Date on which you ceased paying wages, if later than the date shown in A or B.
Enter the name, business address and telephone number of the person in possession of all of your payroll and employment records which pertain to periods prior to the latest date given in A, B or C.
If the business is closing, skip all other questions and sign on the last page.
3. Reorganization, Sale or Other Organizational Change
Under 3. Reorganization, Sale or Other Organizational Change, check all items that apply to you. If any item in this section is checked, please complete numbers 4 & 5.
For Sale of enterprise, mark Entirely or In part (Explain).
For Lease of enterprise, mark Entirely or In part (Explain).
For Change in type of business structure, mark From and To: Corporation, Partnership, Sole Proprietorship or Other (Explain, e.g., Limited Liability Company, Trust, Association, Receivership), and enter the FEIN.
Mark Partnership reorganization or Corporate merger, consolidation or reorganization, and Explain in detail.
Mark Assignment for benefit of creditors, Bankruptcy, Foreclosure or Receivership; enter the Case Number, Date and Type of bankruptcy.
For Death of: Partner or Owner, enter the Name of deceased.
Signed by, Title and Home address of official
Enter the Date signed and submitted, Business name, Signed by, Title, Home address of official and Home telephone number.
More rules for Form UI-50A
Please answer these questions carefully. Your answers may impact upon your liability for unemployment insurance contributions.
Disclosure of this information is Required.
If you reorganized, sold or transferred your business
You reorganized, sold your business or transferred your employees to another business enterprise
If you reorganized, sold your business or transferred your employees to another business enterprise, you must also complete the following pages.
Under 4., if any of the items in #3 are checked, furnish the following information: Date of transaction, Name of new owner and Doing business as (if known).
Under 4., enter the Fed. ID. Number (if known), the Illinois U.I. account number (if known) and the Address.
Under 5., furnish the following information with respect to your Illinois operations if you disposed of or leased only a portion of your business enterprise. A. Did you operate at more than one location in Illinois? If No, skip to E.
B. Did the new owner acquire all of your business locations in Illinois? Mark No or Yes.
C. What number of locations did the new owner acquire?
D. List the name and address of the Illinois business locations you retained or continued to operate: (If necessary, attach an additonal sheet of paper.)
E. Is the Illinois business still owned, managed or controlled in any way by the same interests that owned, managed or controlled the former business? Mark No or Yes.
F. Did the new owner acquire all of the Illinois operations? If No, what is the percentage acquired by the new entity?
G. Is the new owner employing all of the same people that you did on the last day of business? If No, how many people were employed by you? How many of them does the new owner employ?
H. Did the new owner acquire any of your assets? If yes, what %? Mark No or Yes.
I. Did the new owner acquire any of your Illinois trade or business? If yes, what %? Mark No or Yes.
J. What was your trade or business ?
K. Is the new owner conducting the Illinois business which the new owner acquired? Mark No or Yes. If No, are you conducting the business? Mark No or Yes. If neither you nor the new owner, who is conducting the business? Enter Name, Address and Phone Number.
L. Is this business a franchise? If Yes, were you the Franchisee or the Franchisor? Mark No or Yes for L.
Common questions about Form UI-50A
Is there a penalty?
Failure to disclose this information may result in statutorily prescribed liability and sanction, including penalties and/or interest.
Sources
[1] Form UI-50A (Rev. 11/17), Notice of Change, Illinois Department of Employment Security (the Official source link on this page).
