Form ES-802O "Election of Employer's Option to Become Liable for Payments in Lieu of Contributions" - New Mexico

This "Form Es-802o "election of Employer'S Option to Become Liable for Payments in Lieu of Contributions" - New Mexico" is a part of the paperwork released by the New Mexico Department of Workforce Solutions specifically for New Mexico residents.

The latest fillable version of the document was released on July 1, 2007 and can be downloaded through the link below or found through the department's forms library.

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Download Form ES-802O "Election of Employer's Option to Become Liable for Payments in Lieu of Contributions" - New Mexico

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STATE OF NEW MEXICO
DEPARTMENT OF WORKFORCE SOLUTIONS
401 Broadway, NE
PO Box 1928
Albuquerque, NM 87103
ELECTION OF EMPLOYER’S OPTION TO BECOME LIABLE FOR
PAYMENTS IN LIEU OF CONTRIBUTIONS
TO:
New Mexico Department of Workforce Solutions
PO Box 1928
Albuquerque, NM 87103
Pursuant to the provisions of Section 51-1-13 NMSA 1978 and Regulation 11.3.400.421, the undersigned,
an employing unit subject to the said Act, does hereby elect to make payments in lieu of contributions
beginning on ______________________________, and for a period of not less than two consecutive
calendar years.
Employing Unit is applying under NMSA 1978 Section 51-1-13. Government entities are not
required to send the attachments below:
Completed Online Registration
Copy of the IRS Exemption under Section 501(c)(3) of the IRS Code.
Surety Bond
Employing Unit is applying under NMSA 1978 Section 51-1-59 Indian Tribes, the employing
unit is to attach the following:
Completed Online Registration
The undersigned requests written approval by the New Mexico Department of Workforce Solutions of this
election.
Enter the Taxable Wages paid during the prior four (4) calendar quarters ending June 30. If no wages were
paid during the preceding four (4) calendar quarters ending June 30, please estimate the amount to be paid.
1
Quarter 20_______$____________________
3
Quarter 20_______$___________________
st
rd
2
Quarter 20_______$___________________
4
Quarter 20_______$___________________
nd
th
_____________________________________________
__________________________
LEGAL NAME OF EMPLOYER
DATE
______________________________________
________________________________
Prepared by
Title
DECLARATION OF VERIFYING OFFICER: The above person whose signature appears on this document is a duly
authorized representative of the employing unit, empowered to exercise this option.
The above election commencing as of _________________________, 20________ is
Approved
Disapproved
Account No. ________________________
By:_______________________________________________
Date:___________________
Title:______________________________________________
ES-802O, Rev 7.07
STATE OF NEW MEXICO
DEPARTMENT OF WORKFORCE SOLUTIONS
401 Broadway, NE
PO Box 1928
Albuquerque, NM 87103
ELECTION OF EMPLOYER’S OPTION TO BECOME LIABLE FOR
PAYMENTS IN LIEU OF CONTRIBUTIONS
TO:
New Mexico Department of Workforce Solutions
PO Box 1928
Albuquerque, NM 87103
Pursuant to the provisions of Section 51-1-13 NMSA 1978 and Regulation 11.3.400.421, the undersigned,
an employing unit subject to the said Act, does hereby elect to make payments in lieu of contributions
beginning on ______________________________, and for a period of not less than two consecutive
calendar years.
Employing Unit is applying under NMSA 1978 Section 51-1-13. Government entities are not
required to send the attachments below:
Completed Online Registration
Copy of the IRS Exemption under Section 501(c)(3) of the IRS Code.
Surety Bond
Employing Unit is applying under NMSA 1978 Section 51-1-59 Indian Tribes, the employing
unit is to attach the following:
Completed Online Registration
The undersigned requests written approval by the New Mexico Department of Workforce Solutions of this
election.
Enter the Taxable Wages paid during the prior four (4) calendar quarters ending June 30. If no wages were
paid during the preceding four (4) calendar quarters ending June 30, please estimate the amount to be paid.
1
Quarter 20_______$____________________
3
Quarter 20_______$___________________
st
rd
2
Quarter 20_______$___________________
4
Quarter 20_______$___________________
nd
th
_____________________________________________
__________________________
LEGAL NAME OF EMPLOYER
DATE
______________________________________
________________________________
Prepared by
Title
DECLARATION OF VERIFYING OFFICER: The above person whose signature appears on this document is a duly
authorized representative of the employing unit, empowered to exercise this option.
The above election commencing as of _________________________, 20________ is
Approved
Disapproved
Account No. ________________________
By:_______________________________________________
Date:___________________
Title:______________________________________________
ES-802O, Rev 7.07
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