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Colorado Department of Labor and Employment	303-318-9100 (Denver-metro area) or
Unemployment Insurance Employer Services	1-800-480-8299 (outside Denver-metro area)
P.O. Box 8789, Denver, CO 80201-8789	www.colorado.gov/cdle/ui

EMPLOYER CHANGE REQUEST

Please type or use black ink and return to the above address. Instructions are on page 2. If you have any questions, call one of the above telephone numbers.

PART I—EMPLOYER INFORMATION.

All information in Part I must be completed by the person making the change request.

INFORMATION

Owner, Partners, or Corporate Name

Employer Account Number

Trade Name

Street Address

City

State

ZIP Code

PRIOR

The form must be signed in Part IV; if this form is not signed, it cannot be processed.

PART II—CHANGE OF OWNERSHIP/TERMINATION OF BUSINESS OR EMPLOYMENT

Sole proprietorship or partnership incorporating are considered as new businesses. Change of ownership includes changing 50

percent or more in a partnership.

NOTE: Do not complete this form if you are only transferring corporate stock.

Date of termination or change: _______/______/______.

b. Date employer in Part I last paid wages:____/____/_____.

Did the employer in Part I have seasonal status with the Division?

Yes

3. Reason for change or termination:

a. Business closed

e. Partial sale of business (Contact the

g. Incorporation

b. No paid employees

Department for information concerning

h. Merger

(Include corporate officers)

partial transfer of experience rate to the

i. Other _____________

c. Consider workers to be contract

buyer)

__________________

labor

f. All employees being reported by

employee leasing company or

d. Sale of entire business (All

management company

locations)

Name:

INFORMATION

Account Number:

4. a. Will the employer in Part I continue to have employees in Colorado?

Yes

b. If boxes d, e, f, g, h, or i are checked above, the new employer listed below must complete Form UITL-100, Application for

Unemployment Insurance Account and Determination of Employer Liability.

1. Name of new employer ________________________________________________________________________________

2. Trade name of new employer ___________________________________________________________________________

3. Address of new employer ______________________________________________________________________________

NEW

c. If partial sale, were any employees transferred from the employer in Part I to the new employer listed above?

Yes

If Yes, 1. How many employees were transferred? ___________________________

2.List the total number of employees in your entire business in each of your four pay periods preceding the date of sale. This includes all employees in the portion sold and all employees in the portion retained.

______________________ ____________________ _____________________ ____________________

	PART III—CHANGE OF NAME OR ADDRESS ONLY (Must also complete Part I with previous address)
	If this is a change of address, this change is for:	Physical location address		Mailing address for ALL premium information
	Mailing address for all benefits information				Trade name change
	New Partner(s), Corporate Name (If a corporate name change, include a copy of the Certificate of Amendment)

	New Trade Name

	New In Care of Name (if applicable)				Telephone Number

	New Street		City		State		ZIP Code

REQUIRED INFORMATION	PART IV—CERTIFICATION OF CHANGE
REQUIRED INFORMATION	I certify that I am authorized to make this report and the information is correct.

	Signature					Date

	Title					Telephone Number

UITL-2 (R 08/2010)

INSTRUCTIONS FOR COMPLETING THE EMPLOYER CHANGE REQUEST

Requirements for completing the form:

1.All information in Part I must be completed.

2.Complete Part II if there is a change in the business ownership or termination of business.

3.Complete Part III if there is a change in the mailing address.

4.Part IV must be signed for any change to be made.

NOTE: If there are distribution points assigned for the business, complete a separate form for each distribution point account number to be changed.

Instructions for completing this form:

PART I—EMPLOYER INFORMATION

1.Owner, partners, or corporate name–the entity (owner) name.

2.Account number—The Colorado unemployment insurance (UI) account number is required.

3.Trade name—The name the business is “doing business as.”

4.Street address, city, state, and ZIP code—The current mailing address of the business that is on record for Colorado UI purposes.

PART II—CHANGE OF OWNERSHIP/TERMINATION OF BUSINESS OR EMPLOYMENT

1.The date the business was sold or closed.

2.The date the last wages were paid to any employees by the employer in Part I.

3.Indicate if business in Part I was designated as a seasonal employer by UI Employer Services.

4.Check the reason

NOTE: If a change in the interest of a partnership is less than 50 percent, there will not be an entity change, only a name change (see Part III).

5.Complete for the sale of all or any part of the business, transfer of employees to an employee leasing/management company, incorporation, or merger.

•Be sure to include the name and address of the new employer.

•If this is a partial sale of the business, list how many employees were transferred to the new employer.

6.Form UITR-14, Application for Partial Transfer of Experience, must be filed within sixty (60) days after the notice of employer liability is mailed to the successor employer. A partial transfer of experience will be made if the criteria for a segregable unit as defined by the Colorado Employment Security Act 8-76-104 (5)(g) is met.

PART III—CHANGE OF NAME OR ADDRESS ONLY

NOTE: To make any address change, all information must be completed in Part I.

1.Mark the appropriate box or boxes to change the mailing address for UI information and/or UI benefits information. The address change cannot be made without this information.

2.New, partner(s), or corporate name change—If a partnership, print the names of all partners of the business, not just the changes. If a corporate name change, be sure to include a copy of the Certificate of Amendment from the Secretary of State.

3.Complete if there is a change, addition, or deletion of trade name.

4.Address—Include the complete mailing address for the business, not just the change.

PART IV—CERTIFICATION OF CHANGE

1.Signature—The signature of the person requesting the change to the UI account.

2.Title—The title of the person requesting the change to the account (e.g., owner, corporate secretary, or employer representative).

3.Phone—The phone number to call if any additional information is required.

4.Date—The date the form is completed.

UITL-2 Page 2 (R 08/2010)

Question	Answer
Form Name	Uitl 2 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	colorado uitl 2 form, name ui colorado, colorado uitl 2, colorado employer change

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