Form C-1AM "Amended Status Report" - Texas

What Is Form C-1AM?

This is a legal form that was released by the Texas Workforce Commission - a government authority operating within Texas. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on June 26, 2015;
  • The latest edition provided by the Texas Workforce Commission;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form C-1AM by clicking the link below or browse more documents and templates provided by the Texas Workforce Commission.

ADVERTISEMENT
ADVERTISEMENT

Download Form C-1AM "Amended Status Report" - Texas

787 times
Rate (4.8 / 5) 55 votes
Amended Status Report
Mail To:
This form can be completed online at
Cashier - Texas Workforce Commission
www.texasworkforce.org
P.O. Box 149037
Austin, TX 78714-9037
This report is to update your account with TWC
512.463.2731
*Indicates required information.
Identification Section
*1. Account Number assigned by TWC
*5. Federal Employer ID Number
*2. Name
*6. Area Code/Phone Number
*3. Mailing address
*7. Address where payroll records are kept
*4. City, State, Zip
*8. City, State, Zip where payroll records are kept
*9. Owners or Officers
Name
Soc. Sec. No.
Title
Residence Address, City, State
10. Business locations in Texas
Trade Name
Street Address, City
Kind of Business
No. Employees
Acquisition Section
11. If you acquired the business in Texas from a previous owner, you must complete Items 11-13.
If a partial acquisition, the predecessor/successor may jointly submit an application for partial transfer of experience.
a. Acquisition Date :
Month
Day
Year
b. Previous Owner’s TWC Account Number (if known):
c. Previous Owner’s Name:
d. Previous Owner’s Address:
e. City, State, Zip:
f. Portion of business acquired:
(check one):
All
Part (specify which part of business was purchased)
12. On the date of the acquisition, was the previous owner(s), or any partner(s), officer(s), shareholder(s), other owner(s) or a person elated by blood or marriage to any
of these individuals, holding a legal or equitable interest in the predecessor business, also an owner, partner, officer, shareholder, or other owner of a legal or equitable
interest in the successor business?
Yes
No
If “Yes”, check all that apply:
Same owner, officer, partner, or shareholder
Same parent company
Sole proprietor incorporating
Other if other, please describe______________________________________________________________________________________
If “No”, on the date of the acquisition, did the previous owner(s), partner(s), officer(s), shareholder(s), other owner(s) or a person elated by blood or marriage to any of
these individuals, holding a legal or equitable interest in the predecessor business, hold an option to purchase such an interest in the successor business?
Yes
No
13. After the acquisition, did the predecessor continue to:
Own or manage the organization that conducts the organization, trade or business?
Own or manage the assets necessary to conduct the organization, trade or business?
Control through security or lease arrangement, the assets necessary to conduct the organization, trade or business?
Direct the internal affairs or conduct of the organization, trade or business?
Yes
No
If “Yes" to any of above, describe:
Page 1 of 2
C-1AM (062615)
Amended Status Report
Mail To:
This form can be completed online at
Cashier - Texas Workforce Commission
www.texasworkforce.org
P.O. Box 149037
Austin, TX 78714-9037
This report is to update your account with TWC
512.463.2731
*Indicates required information.
Identification Section
*1. Account Number assigned by TWC
*5. Federal Employer ID Number
*2. Name
*6. Area Code/Phone Number
*3. Mailing address
*7. Address where payroll records are kept
*4. City, State, Zip
*8. City, State, Zip where payroll records are kept
*9. Owners or Officers
Name
Soc. Sec. No.
Title
Residence Address, City, State
10. Business locations in Texas
Trade Name
Street Address, City
Kind of Business
No. Employees
Acquisition Section
11. If you acquired the business in Texas from a previous owner, you must complete Items 11-13.
If a partial acquisition, the predecessor/successor may jointly submit an application for partial transfer of experience.
a. Acquisition Date :
Month
Day
Year
b. Previous Owner’s TWC Account Number (if known):
c. Previous Owner’s Name:
d. Previous Owner’s Address:
e. City, State, Zip:
f. Portion of business acquired:
(check one):
All
Part (specify which part of business was purchased)
12. On the date of the acquisition, was the previous owner(s), or any partner(s), officer(s), shareholder(s), other owner(s) or a person elated by blood or marriage to any
of these individuals, holding a legal or equitable interest in the predecessor business, also an owner, partner, officer, shareholder, or other owner of a legal or equitable
interest in the successor business?
Yes
No
If “Yes”, check all that apply:
Same owner, officer, partner, or shareholder
Same parent company
Sole proprietor incorporating
Other if other, please describe______________________________________________________________________________________
If “No”, on the date of the acquisition, did the previous owner(s), partner(s), officer(s), shareholder(s), other owner(s) or a person elated by blood or marriage to any of
these individuals, holding a legal or equitable interest in the predecessor business, hold an option to purchase such an interest in the successor business?
Yes
No
13. After the acquisition, did the predecessor continue to:
Own or manage the organization that conducts the organization, trade or business?
Own or manage the assets necessary to conduct the organization, trade or business?
Control through security or lease arrangement, the assets necessary to conduct the organization, trade or business?
Direct the internal affairs or conduct of the organization, trade or business?
Yes
No
If “Yes" to any of above, describe:
Page 1 of 2
C-1AM (062615)
Reopen Section
14. If you are filing this report to reactivate your inactive account, complete this section.
The date you resumed employing individuals in Texas:
Month
Day
Year
The date you resumed paying wages in Texas:
Month
Day
Year
Suspend Section
If you sold a business in Texas you must complete Items 15 through 17
15. If you are filing this report to inactivate your account, complete this section.
The last day on which individuals performed services in Texas:
Month
Day
Year
The date on which final wages were paid:
Month
Day
Year
Employment in Texas was discontinued because: (Check one):
Business discontinued entirely without a successor.
Business continued without employment.
Business, trade or organization was acquired by a successor.
If a partial acquisition, the predecessor/successor may jointly submit an application for partial transfer of experience.
Successor’s TWC Account Number (if known):
Successor’s Name:
Successor’s Address:
City, State, Zip:
Successor Acquired:
All the Texas business or assets.
(Check one):
Part of the Texas business or assets. Part Acquired (specify):
16. On the date of the acquisition, was the previous owner(s), or any partner(s), officer(s), shareholder(s), other owner(s) or a person related by blood or marriage to
any of these individuals, holding a legal or equitable interest in the predecessor business, also an owner, partner, officer, shareholder, or other owner of a legal or
equitable interest in the successor business?
Yes
No
If “Yes”, check all that apply:
Same owner, officer, partner or shareholder
Sole proprietor incorporating
Same parent company
Other (Described below)
________________________________________________________
If “No”, on the date of the acquisition, did the previous owner(s), partner(s), officer(s), shareholder(s), other owner(s) or a person related by blood or marriage to any of
these individuals, holding a legal or equitable interest in the predecessor business, hold an option to purchase such an interest in the successor business?
Yes
No
17. After the acquisition, did the predecessor continue to:
Own or manage the organization that conducts the organization, trade of business?
Own or manage the assets necessary to conduct the organization, trade or business?
Control through security or lease arrangement the assets necessary to conduct the organization, trade or business?
Direct the internal affairs or conduct of the organization, trade or business?
Yes
No
If “Yes” to any of above, describe:
Signature Section
*18. I hereby certify that the preceding information is true and correct, and that I am authorized to execute this Amended Status Report on behalf of the employing unit
named herein. (This report must be signed by the owner, officer, partner OR individual with a valid Written Authorization on file with the Texas Workforce
Commission.)
Date of signature:
Title
_______________
Month
___ Day
___ Year
___
Sign here ________________________________________
Driver's license number
_____________________
State
_____________________
E-mail address
_________________
Individuals may receive, review, and correct information that TWC collects about the individual by emailing to
open.records@twc.state.tx.us
or writing to TWC Open
th
Records, 101 East 15
St., Rm. 266, Austin, TX 78778-0001.
Page 2 of 2
C-1AM (062615)
Page of 2