Form NYS100AG "New York State Employer Registration for Unemployment Insurance, Withholding, and Wage Reporting for Agricultural Employment" - New York

What Is Form NYS100AG?

This is a legal form that was released by the New York State Department of Labor - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the New York State Department of Labor;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form NYS100AG by clicking the link below or browse more documents and templates provided by the New York State Department of Labor.

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Download Form NYS100AG "New York State Employer Registration for Unemployment Insurance, Withholding, and Wage Reporting for Agricultural Employment" - New York

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Department of Taxation and Finance and
Department of Labor
Unemployment Insurance Division
New York State Employer Registration
Registration Section
for Unemployment Insurance,
Harriman State Office Campus, Building 12
Withholding, and Wage Reporting for
Albany, New York 12240-0339
Agricultural Employment
For office use only:
Unemployment Insurance
Registration Number:
Return completed form (type or print in ink) to the
address above, or fax to (518) 485-8010.
Need Help? Call the Employer Hotline at (888) 899-8810
Part A - Employer Information
1. Legal Entity (check one):
Sole Proprietorship
Partnership
Corporation (includes Sub-Chapter S)
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
Other (please describe):
2. Federal Employer Identification Number (FEIN):
3. Telephone number: (
)
4. Fax number: (
)
5. Legal name of business:
6. Trade name (doing business as), if any:
7. Business email:
8. Website:
Part B - Liability Information
1. Enter date of first operations in New York State:
/
/
(mm/dd/yyyy)
2. Enter the date of the first payroll you withheld (or will withhold) New York State Income Tax from your employees’ pay:
/
/
(mm/dd/yyyy)
3. Enter the first calendar quarter in which you paid (or expect to pay) total remuneration of $300 or more. This
includes payments to employees or to corporate and Sub-Chapter S officers for services.
Jan 1 – Mar 31 (1st)
Apr 1 – Jun 30 (2nd)
Jul 1 – Sep 30 (3rd)
Oct 1 – Dec 31 (4th) Year
4. Total number of covered employees:_____________________
5. Do persons work for you whom you do not consider employees?
Yes*
No
*If yes, what services do they perform and why do you not consider them employees?
NYS100AG (11/19)
Page 1 of 9
Department of Taxation and Finance and
Department of Labor
Unemployment Insurance Division
New York State Employer Registration
Registration Section
for Unemployment Insurance,
Harriman State Office Campus, Building 12
Withholding, and Wage Reporting for
Albany, New York 12240-0339
Agricultural Employment
For office use only:
Unemployment Insurance
Registration Number:
Return completed form (type or print in ink) to the
address above, or fax to (518) 485-8010.
Need Help? Call the Employer Hotline at (888) 899-8810
Part A - Employer Information
1. Legal Entity (check one):
Sole Proprietorship
Partnership
Corporation (includes Sub-Chapter S)
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
Other (please describe):
2. Federal Employer Identification Number (FEIN):
3. Telephone number: (
)
4. Fax number: (
)
5. Legal name of business:
6. Trade name (doing business as), if any:
7. Business email:
8. Website:
Part B - Liability Information
1. Enter date of first operations in New York State:
/
/
(mm/dd/yyyy)
2. Enter the date of the first payroll you withheld (or will withhold) New York State Income Tax from your employees’ pay:
/
/
(mm/dd/yyyy)
3. Enter the first calendar quarter in which you paid (or expect to pay) total remuneration of $300 or more. This
includes payments to employees or to corporate and Sub-Chapter S officers for services.
Jan 1 – Mar 31 (1st)
Apr 1 – Jun 30 (2nd)
Jul 1 – Sep 30 (3rd)
Oct 1 – Dec 31 (4th) Year
4. Total number of covered employees:_____________________
5. Do persons work for you whom you do not consider employees?
Yes*
No
*If yes, what services do they perform and why do you not consider them employees?
NYS100AG (11/19)
Page 1 of 9
6. If you are not liable under the Unemployment Insurance Law for agricultural employment, do you wish to elect voluntary
coverage?
Yes
No
7. Have you acquired the business of another employer liable for New York State Unemployment Insurance?
Yes*
No
If Yes, did you acquire
All or
Part of the business? Date of acquisition:
/
/
(mm/dd/yyyy)
Prior owner’s Registration Number:
Prior owner’s FEIN:
Legal name of business:
Address:
8. Have you changed legal entity?
Yes*
No
If yes, date of legal entity change:
/
/
(mm/dd/yyyy)
Prior employer’s Registration Number:
Prior employer’s FEIN:
Part C - Required Addresses
1. Mailing Address: This is your business mailing address where your Withholding Tax and Unemployment
Insurance mail will be delivered. If you elect to have your Unemployment Insurance mail directed to an address
other than your place of business, complete number 4.
ATTN:
Street or PO box:
City:
State:
Zip code:
County:
Country:
2. Physical Address: This is the physical location of your business, if different from the Mailing Address in number 1.
Street:
City:
State:
Zip code:
County:
Country:
3. Location of Books/Records: This is the physical location where you keep your Books and Records.
C/O (if applicable):
Street:
City:
State:
Zip code:
County:
Country:
Telephone number:(
)
ext:
Contact name:
NYS100AG (11/19)
Page 2 of 9
Optional Addresses
4. Agent Address (C/O): Complete this if your Unemployment Insurance mail should be sent to an address other than
your business address:
C/O:
Street or PO box:
City:
State:
Zip code:
County:
Country:
Telephone number: (
)
ext:
Contact name:
5. LO 400 Form - Notice of Potential Charges Address: This is sent each time a former employee files a claim for
Unemployment Insurance benefits. You can sign up for SIDES to receive this notice electronically. See instructions or visit
our website at www.labor.ny.gov for additional information. Otherwise, complete below:
C/O:
Street or PO box:
City:
State:
Zip code:
County:
Country:
Telephone number:(
)
ext:
Contact name:
Part D - Business Information
1. Complete the following for sole proprietor (owner), all partners, including partners of LP, LLP or RLLP, all members of
LLC or PLLC, and corporate officers (President, Vice President, etc.). Complete this section whether or not
remuneration is received, or services are performed in New York State. If needed use a separate sheet of paper.
Name
Social Security
Title
Residence Address and Phone Number
Number
NYS100AG (11/19)
Page 3 of 9
2. Enter the number of physical locations at which your company operates in New York State:
. You must list the
physical address and answer questions a and b below, for each location. Use a separate sheet of paper for each.
a. Location (number and street):
City:
County:
Zip code:
b. How many employees at this location?
3. Indicate your principle activity or farm production that produces the greatest gross sales and specify type:
Oilseed and Grain: specify type:
Vegetable and Melon; specify type:
Fruit and Tree Nut, specify type:
Greenhouse, Nursery and Floriculture Production, specify type:
Other Crop, specify type:
Cattle Ranching and Farming, specify type:
Hog and Pig Farming, specify type:
Poultry and Egg Production, specify type:
Sheep and Goat Farming, specify type:
Aquaculture/Other Animal Production, specify type:
Other: (provide details):
AFFIRMATION
I affirm that I have read the above questions and that the answers provided are true to the best of my knowledge and
belief.
/
/
Signature of Officer, Partner, Proprietor, Member or Individual
(mm/dd/yyyy)
(
)
Official Position
Telephone number
Email address
NYS100AG (11/19)
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General Information
Employers of agricultural workers become liable for unemployment insurance contributions:
as of the first day of the calendar quarter in which they pay total remuneration of $300 or more, or as of the date they
purchase the business of another liable employer or otherwise become successor to that employer.
A farm labor crew leader would also become liable if they meet any of the conditions above and:
• They are not the employee of the farm operator, and
They hold a valid certificate of registration under the Farm Labor Contractor Registration Act of 1963, or
substantially all of their crew operates or maintains mechanized equipment which they provide.
Agricultural work is defined in the law as all services performed:
• On a farm, in the employ of any person, in connection with cultivating the soil, or in connection with raising or
harvesting any agricultural or horticultural commodity, including the raising, shearing, feeding, caring for, training and
management of livestock, bees, poultry, and fur-bearing animals, and wildlife.
In the employ of the owner or tenant or other operator of a farm in connection with the operation, management,
conservation, improvement, or maintenance of such farm and its tools and equipment, or in salvaging timber or
clearing land of brush and other debris left by a hurricane, if the major part of such service is performed on a farm.
In handling, planting, drying, packing, packaging, processing, freezing, grading, storing, or delivering to storage or to
market or to a carrier for transportation to market, any agricultural or horticultural commodity, but only if such service is
performed in the employ of an operator of a farm (i) as an incident to farming operations or (ii) in the case of fruits and
vegetables, as an incident to the preparation of such fruits or vegetables for market. The provisions of this paragraph
shall not apply to service performed in connection with any agricultural or horticultural commodity after its delivery to a
terminal market for distribution for consumption.
The term farm includes stock, dairy, poultry, fur bearing animals, fruit and truck farms, plantations, nurseries, greenhouses
or similar structures, used primarily for the raising of agricultural or horticulture commodities, and orchards.
NYS100AG (11/19)
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