State Form 46799 - Report Of Transfer - Complete Sale
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1INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT
REPORT OF TRANSFER - COMPLETE SALE
10 N. SENATE AVE.
State Form 46799 (R/2-96)
INDIANAPOLIS IN 46204-2277
(317) 232-7436
•
To be filed by the previous owner (disposer).
•
This must be submitted within 10 days after disposing and acquiring employers are mailed final notice.
•
Any employing unit which fails to submit any report required within 10 days after request is sent by registered mail shall be
assessed a penalty of $25.00. Reference Indiana Code 22-4-19-10.
•
Any employing unit shall have 15 days within which to protest in writing determinations with respect to successorship's . . . period
shall commence the day following the day upon which the determination is mailed. Reference Indiana Code 22-4-32-4.
NOTE:
If you disposed of, or leased, only a portion of your Indiana business assets, do not complete this form. You are
required to complete State Form 23299, Report of Transfer - Partial Sale.
(check one)
This report must be filed if:
Sale of Complete organization
Corporate change or reorganization
Partnership change (50% or more)
Changed Federal ID number
Death of owner or partner
Lease of Complete organization
(explain fully):
Other
Please type or print in ink.
FOR OFFICE USE ONLY
Disposition
(mm/dd/yy)
Effective date of change:
Date
Disposition
(mm/dd/yy)
Date disposer operations ceased:
Code
Audit
(mm/dd/yy)
Date of last payroll for disposer organization:
Examiner
Date
(
)
-
Disposer's Indiana SUTA No.:
FEIN:
Completed
Merit Rate
Requested
Legal name of employing unit:
Fed. Cert.
Requested
d/b/a:
Business activity:
Current address:
PO Box
City:
State:
ZIP Code
__ __ __ __ __ - __ __ __ __ - __ __ - __
(
)
-
Contact person:
Telephone No.:
Ext.:
(
)
-
FEIN:
Acquirer's Indiana SUTA No.:
Legal name of employing unit:
d/b/a:
Business activity:
Current address:
PO Box
City:
State:
ZIP Code
__ __ __ __ __ - __ __ __ __ - __ __ - __
(
)
-
Telephone No.:
Ext.:
Contact person:
If you sell "substantially all the assets within (Indiana)" but keep the corporation, that is a complete sale (disposition) under Indiana
Code 22-4-7-2-a.
(attach any related legal documents):
Explain fully any special circumstances
I certify that the information contained in this report is true and correct.
(
)
-
Authorized Signatu
re
Telephone Number
Extension
Date
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