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COMMONWEALTH of VIRGINIA

COMMONWEALTH of VIRGINIA . VIRGINIA Employment Commission Tired of paperwork? We can help! Make Changes to your Report to Determine Liability (T-FC-27) Unemployment Insurance tax account online. It's fast, easy, accurate, and secure! Account Federal ID Number: Number: Type of Organization: Submit to: Sole VEC. Individual Corporation LLC LLP. Proprietor Attn: Employer Accounts General Limited Box 1358, Government Other_____. Parternship Partnership Richmond, VA 23218-1174. Are you a Professional Employer If yes, attach a list of all clients containing client State of Incorporation or Formation: Organization(PEO)? Yes No name, address, Fed ID#, and contract begin date. Employer Name: Doing Business As: Attention: Business Mailing Address: Address 1: Address 2: City: Zip State: Code: County: Phone Fax Number: Number: Business Location Address:(If more than one VA location, attach list of other addresses). Select one of the following: Physical Location Employee Residence Job/Worksite Address 1: Address 2: Zip State: Code: Name the VIRGINIA CITY or VIRGINIA COUNTY in which the business is located (Specify location where work is actually performed).

Page 1 of 2 COMMONWEALTH of VIRGINIA Virginia Employment Commission Equal Opportunity Employer/Program Auxiliary Aids and Services Are Available Upon Request to Individuals with Disabilities

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