UCE-1010 (Rev. 12/7/18) WRITTEN AUTHORIZATION Please read the instructions following this form before completing. By completing this form, you are authorizing the South Carolina Department of Employment and Workforce (DEW) to disclose/discuss Unemployment Insurance (UI) related matters to your chosen agent. This form is only to be used to designate an agent. If you are attempting to add or remove authorized contact persons, do not complete this form. Please refer to the attached instructions for more information. PART 1: EMPLOYER INFORMATION Name and Address: (if individual) If a business entity, enter DBA, trade or assumed name: FEIN: DEW Account #: Telephone Number (required): Extension: Fax Number: Email Address: PART 2: AGENT INFORMATION AND AUTHORIZATION DATES Your authorized agent may be an organization, firm, or individual. If your agent is not an individual, designate a contact person. Please ensure that you submit a separate form for each agent. (NOTE: Only one agent can occupy each role during any given time period.) Agent Name and Address Contact Name (if applicable): Agent FEIN (if any): SUITS Agent Account #: Telephone Number (required): Extension: Fax Number: Email Address: Beginning Effective Date (required)*: Ending Effective Date – (Optional)**: PART 3: TYPE OF AUTHORIZATION GENERAL AUTHORIZATION Authorizes my agent to: (1) submit wage reports, (2) submit payments and enter into payment agreements, (3) perform account maintenance updates, (4) submit and receive information related to UI benefits. This authorization applies to all tax and benefit related matters. LIMITED AUTHORIZATION Select the type of authorization by checking the appropriate boxes to the right of each item listed below. You may check up to 3 boxes. If 4 boxes apply, please complete the ‘General Authorization’ above. 1. Wage Submission (Original and Amended) ........................................................ IMPORTANT: Completing this form will not 2. Payment Submission and Payment Agreements .................................................. change an employer’s address of record. 3. Account Maintenance Updates ............................................................................ Address changes must be made through SUITS. 4. Benefits (UI Benefit related matters) ................................................................... PART 4: AUTHORIZATION AND RELEASE FOR DISCLOSURE OF UI TAX AND/OR UI BENEFIT INFORMATION/RECORDS I understand that any information or records obtained by DEW in the administration of the Unemployment Insurance program is generally private and confidential pursuant to S.C. Code Ann. § 41-29-160 and 20 CFR Part 603, and may only be released for the purpose specified in this Written Authorization in accordance with state and federal law. By signing this Written Authorization, I am authorizing DEW to release the information specified to the authorized agent. I understand state government files will be accessed to obtain the information disclosed to the authorized agent. I further understand that I am authorizing the appointed agent to act on behalf of the business to the fullest extent to which I could act if I were personally present in connection with the transactions authorized in Part 3 of this Written Authorization.I further declare the information submitted has been examined by me and I specifically authorize agent(s) to transact the above specified UI business with DEW. Name (Print )_________________________________________________________________Title ________________________________________________________ Signature _________________________________________________________Date _________________ Phone No. _________________________________________ In order for this application to be processed, the signatory must be on file with DEW as a business owner, officer, partner or agent duly authorized to act on behalf of this employer. * If you are authorizing agent to submit wage reports, please note that DEW will make the effective date of that authorization retroactive to the beginning of the quarter in which the date you provide falls. ** If no “Ending Effective Date” is provided, the above-named agent will be authorized to represent you until you notify ETS in writing that you wish to change your agent. |
Instructions for Written Authorization Form (Form UCE-1010) Complete and file a Written Authorization (Form UCE-1010) if you wish to appoint or replace an individual, firm or organization as your agent in unemployment insurance (UI) tax matters before the South Carolina Department of Employment and Workforce (DEW). If you are the employer, this form is not to be used to add or remove an individual contact person or additional user to your Self-Service Portal in SUITS. This form is only to designate your agent who will have access to designated account information through that agent’s Self-Service Portal in SUITS. Unless otherwise specified, this Written Authorization Part 4: Certification and Signature replaces any previous applicable Written Authorization In order for this application to be processed, the signatory forms on file with DEW. Without a completed form, must be on file with DEW as a business owner, officer, DEW is prohibited from discussing or releasing your partner or agent duly authorized to act on behalf of this confidential employer information to an agent. You employer and. must submit a separate Written Authorization Form for each agent. Please note that only one agent can Submit this Form: occupy a specified roll at any one time Online: The most efficient way to submit this form is Part 1: Employer Information through SUITS, the Department’s new online If you are an individual, enter the name and address: if a system designed to streamline business business entity, enter DBA, trade or assumed name., UI processing. To submit this form using account number, federal employer identification number SUITS, go to uitax.dew.sc.gov. (FEIN), telephone number, fax number, and email • Employer Portal: Select the “Agent address. If you do not have a UI account number, please Assignment” icon under the Account complete and submit Form UCE-151, Employer Status Maintenance screen. Report or register on line through SUITS at • Agent Portal: Select the “Maintain POA” uitax.dew.sc.gov. icon under the Account Maintenance screen. Part 2: Agent Information Mail: SCDEW Enter the agent name and address, contact name (if Document Control Unit applicable), e-mail address, telephone number (required), PO Box 995 extension, fax number, Agent FEIN (if any, SUITS Agent Columbia, SC 29202 Account #, beginning effective date, and ending effective date (if applicable). Questions. Part 3: Type of Authorization Questions regarding this correspondence should be Check the box(es) indicating the information you wish to directed to DEW’s Employer Tax Services using your authorize your agent to receive. If your agent will have Self-Service portal in SUITS, DEW’s online UI tax full authority to act on your business’s behalf with regard system at uitax.dew.sc.gov. to UI tax matters, check only the first box in this section. If you wish to specify limited authority, please check one For instructions on how to use SUITS, please visit or more (up to 3) of the limited authorization boxes as dew.sc.gov/suits. they apply. PLEASE NOTE: Unless otherwise specified, this written authorization replaces any previous written authorization on file with DEW. Furthermore, only one agent can occupy a specified roll at any one time. If you specify a change, all roles that are checked will be handled by the agent designated on this form as of the effective date indicated. Any roles that are left unchecked will remain accessible only by the employer and/or the current designated agent on file. Remove Current Agent If you wish to remove your current agent on file but do not wish to assign a new agent, you must log in to your Employer Self-Service Portal through SUITS. |