Form UI-1 S&P Report to Determine Succession - Illinois

Form UI-1 S&P or the "Report To Determine Succession" is a form issued by the Illinois Department of Employment Security.

The form was last revised in February 1, 2017 and is available for digital filing. Download an up-to-date Form UI-1 S&P in PDF-format down below or look it up on the Illinois Department of Employment Security Forms website.

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State of Illinois
33 South State Street
Department of Employment Security
Chicago, IIllinois 60603
Report to Determine Succession
Please answer these questions carefully. Your answers may impact upon your liability for
Unemployment Insurance contributions.
1 . a. Date of acquisition (or change of business entity, e.g., from a sole proprietorship to a corporation)
b. Is the previous owner still doing business?
Yes
No
c. If No, indicate the date the previous operation ceased doing business.
d. If there is a gap of seven days or more between 1.a. and 1.c., please explain; for example: seasonal business, closed
for remodeling, or other.
2. a. Name of previous owner
Doing business as
What was the previous owner's trade or business?
What was his principal product or service?
% Sales or Receipts
Illinois U.I. account number (if known)
Fed. I.D. Number (if known)
Address:
E-mail Address:
Enter the required information for sole proprietor or each partner or officer:
Name
Title
Social Security No.
Home Address
Home Phone
E-mail address
b. Name of current owner
Doing business as
What is your trade or business?
What is your principal product or service?
% Sales or Receipts
Illinois U.I. account number
Fed. I.D. Number
Address:
E-mail Address:
Enter the required information for sole proprietor or each partner or officer:
Name
Title
Social Security No.
Home Address
Home Phone
E-mail address
Page 1 of 4
UI-1 S&P (Rev. 2-17)
State of Illinois
33 South State Street
Department of Employment Security
Chicago, IIllinois 60603
Report to Determine Succession
Please answer these questions carefully. Your answers may impact upon your liability for
Unemployment Insurance contributions.
1 . a. Date of acquisition (or change of business entity, e.g., from a sole proprietorship to a corporation)
b. Is the previous owner still doing business?
Yes
No
c. If No, indicate the date the previous operation ceased doing business.
d. If there is a gap of seven days or more between 1.a. and 1.c., please explain; for example: seasonal business, closed
for remodeling, or other.
2. a. Name of previous owner
Doing business as
What was the previous owner's trade or business?
What was his principal product or service?
% Sales or Receipts
Illinois U.I. account number (if known)
Fed. I.D. Number (if known)
Address:
E-mail Address:
Enter the required information for sole proprietor or each partner or officer:
Name
Title
Social Security No.
Home Address
Home Phone
E-mail address
b. Name of current owner
Doing business as
What is your trade or business?
What is your principal product or service?
% Sales or Receipts
Illinois U.I. account number
Fed. I.D. Number
Address:
E-mail Address:
Enter the required information for sole proprietor or each partner or officer:
Name
Title
Social Security No.
Home Address
Home Phone
E-mail address
Page 1 of 4
UI-1 S&P (Rev. 2-17)
Check all boxes that apply to you:
3. What is the nature of this acquisition or change of business entity?
A.
Purchase of Business
Entirely
In Part
(Explain)
B.
Lease of Business
Entirely
In Part
(Explain)
C.
Change in Type of Business Entity
From:
Sole Proprietor
Partnership
Corporation
Other
(Explain)
To:
Sole Proprietor
Partnership
Corporation
Other
(Explain)
D.
Corporate Change:
Merger or consolidation
Reorganization
Issuance of new corporate charter
E.
Foreclosure
Receivership
Bankruptcy
If bankruptcy was checked, did you purchase the assets through federal bankruptcy court?
Yes
No
F.
Death of
Owner
Partner
If no, skip to #5.
4. a. Did the former owner operate at more than one location in Illinois?
Yes
No
b. Did you acquire all of the former owner's business locations in Illinois?
Yes
No
c. What number of locations did you acquire?
d. List the name and address of the additional Illinois business locations acquired by you (attach additional sheets if
necessary):
Name and address
City/Town
State
Zip
County
Location 1
Location 2
Location 3
Location 4
Location 5
Location 6
5. Is your Illinois business owned, managed or controlled in any way by the same interests that owned,
Yes
No
managed or controlled the former business?
6. Did you acquire all of the Illinois operations?
Yes
No
%
If No, percent of Illinois operations that you acquired
%
Percent of operations retained by previous owner
7. Are you employing all of the same people that the previous owner did on the last day of business?
Yes
No
If No, how many people were employed by the former owner?
How many of them did you employ?
How many people are you employing?
8. What percent of the former owner's assets did you acquire?
Percent of assets retained by previous owner
9. Did you acquire any of the owner's trade or business?
%
Yes
No
If yes, what percent?
If No, what did you acquire?
Page 2 of 4
UI-1 S&P (Rev. 2-17)
10. Are you conducting the Illinois business you acquired?
Yes
No
If No, is the former owner conducting the business?
Yes
No
If neither you nor the former owner, who is conducting the business?
11. Is this business a franchise?
Yes
No
If Yes, did you acquire this from the
franchisee or from the
franchisor?
CERTIFICATION: I hereby certify that the information contained in this report and any sheets attached hereto is true and correct.
This report must be signed by you, a partner, officer or authorized agent within the employing enterprise. If signed by any other
person, a power of attorney must be attached.
Name of Acquiring Employer
Signature
Title
Date
If you should need further assistance in filling out this form, you may contact the Employer Hot Line Section at telephone
number (800) 247-4984. The TTY number is (866) 212-8831.
This state agency is requesting information that is necessary to accomplish the statutory purpose as outlined
under 820 ILCS 405 / 100 - 3200. Disclosure of this information is REQUIRED. Failure to disclose this
information may result in statutorily prescribed liability and sanction, including penalties and / or interest.
Page 3 of 4
UI-1 S&P (Rev. 2-17)
For a full explanation of succession, visit our web site at www.ides.state.il.us. Click
on Publications and find the Guide to the Illinois Unemployment Insurance Act.
INSTRUCTIONS FOR REPORT TO DETERMINE SUCCESSION
The Department’s determination as to whether you have acquired the employing enterprise of the previous owner may affect the
rate at which you pay contributions.
If you are determined to be a transferee of assets of the previous owner's business, you may be obligated under the
Unemployment Insurance Act for the payment of debts owed by the business.
If you purchase or lease an existing business, in whole or in part or if you change the organization of your business entity (e.g.
from a partnership to a corporation, from a corporation to a proprietorship, etc.), it is required that you fill out this form.
Succession will be determined based upon several criteria. For example:
1. The percentage of the existing business entity that was acquired by you.
2. The percentage of the workers employed by the previous owner that were subsequently employed by you.
3. The percentage of the business assets of the previous owner acquired by you. Assets are defined as inventory, real
property, machinery, accounts receivable, goodwill, etc.
4. Determination of succession is also based upon the amount of time that has elapsed since the previous owner ceased
employing workers in Illinois and the new owner began employing workers.
The purchaser of less than substantially all of another’s business may acquire a portion of that predecessor’s experience under
certain conditions. This transfer is optional and may be beneficial or detrimental.
Page 4 of 4
UI-1 S&P (Rev. 2-13)

Download Form UI-1 S&P Report to Determine Succession - Illinois

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