Notice of Change Form 

All account maintenance can be completed at MyTax.Illinois.gov. Online submission provides a 
confirmation that your submission was received as well as eliminates the wait time associated with 
traditional mail or fax and in many cases can be automatically processed.   

To Change your Name (without change in legal entity), Address, or Phone Number:  

 1. Logon to mytax.illinois.gov 
 2. Select the  Names“ and Address  tab”
 3. Click the hyperlink of the item you want to change. 
 4. Follow and complete steps 

To Close your Account: 

 1. Logon to mytax.illinois.gov 
 2. Go to your  Unemployment“   Insurance Account  ”
 3. Enter the reason for closing your account and enter at least on of the dates requested on the 
    page.  
 4. Under the  Account“ Maintenance  heading” select  Request“ to Close Account  ”
 5. Follow and complete steps 
     
For more information contact IDES Employer Hotline at 1-800-247-4984 

Revised: March 2020                               

                                  Notice of Change
                                  33 South State Street, Chicago, Illinois 60603 
                                  Phone: 800-247-4984  |  Fax : 217-557-1948

Employer Name
DBA Name
                                                                             Account #
Address
City, State, ZIP

                Please answer these questions carefully. Your answers may impact upon your liability for 
                unemployment insurance contributions.

THE EMPLOYING UNIT NAMED ABOVE GIVES NOTICE OF CHANGE(S) WITH RESPECT 
TO ITS BUSINESS EFFECTIVE:
1. Name Change/Address Change/Miscellaneous Changes    Date

Name changed without change in legal entity.   New name
Doing Business As name changed without change in legal entity. New DBA name
Business address changed. New address  
                                                                             (Street)

                           (City)                                                   (State)              (Zip)
                                                     ()
Telephone number changed. New telephone number
Mailing address changed.
If you have multiple mailing addresses, complete UI-1M, Unemployment Insurance Special Mailing Form. 
If the Mailing Address is for an authorized representative, you must attach a Power of Attorney.

                                                                                                         ()
                (Street)          (City)               (State)           (ZIP)                           (Telephone Number)
2. Request to Close Account

A. Date you discontinued operations in Illinois                              Explain

B. Date you ceased employing workers, if you are still operating in Illinois                Explain

C. Date on which you ceased paying wages, if later than the date shown in A or B above
       The name, business address and telephone number of the person in possession of all of your payroll  and employment
       records which pertain to periods prior to the latest date given  in A, B or C

If the business is closing, skip all other questions and sign on the last page. 

If you reorganized, sold your business or transferred your employees to another business enterprise, you must 
also complete the following pages.

UI-50A (Rev. 11 7/1 )                                                                                    Page 1 of 3

                                           Notice of Change
                                       33 South State Street, Chicago, Illinois 60603 
                                       Phone: 800-247-4984  |  Fax : 217-557-1948

3. Reorganization, Sale or Other Organizational Change. Check all items that apply to you. If any item in this section is
checked, please complete numbers 4 & 5 below.
Sale of enterprise:          Entirely;     In part (Explain)
Lease of enterprise:         Entirely;     In part (Explain)
Change in type of business structure
From:
     Sole Proprietorship     Partnership         Corporation            Other (Explain, e.g., Limited Liability Company,
      Trust, Association, Receivership)                                                   FEIN
To:
     Sole Proprietorship     Partnership         Corporation            Other (Explain, e.g., Limited Liability Company,
      Trust, Association, Receivership)                                                   FEIN
   Partnership reorganization (Explain in detail)
   Corporate merger, consolidation or reorganization (Explain in detail)

   Foreclosure;       Receivership;        Bankruptcy;       Assignment for benefit of creditors
   Type of bankruptcy                            Date     /  /            Case Number
   Death of:
                      Owner;       Partner                Name of deceased
4. If any of the items in #3 above are checked, furnish the following information:

Date of transaction
Name of new owner
Doing business as (if known)
Illinois U.I. account number (if known)                      Fed. ID. Number (if known)
Address:
5. Furnish the following information with respect to your Illinois operations if you disposed of or leased only a portion of
your business enterprise:
                                                                                          (If No, skip to E.)
A. Did you operate at more than one location in Illinois?   Yes           No
B. Did the new owner acquire all of your business locations in Illinois?              Yes     No
C. What number of locations did the new owner acquire?
D. List the name and address of the Illinois business locations you retained or continued to operate:
     (If necessary, attach an additonal sheet of paper.)
                  Name and address           City/Town       State                        Zip        County 

     Location 1
     Location 2
     Location 3
     Location 4
     Location 5
     Location 6

UI-50A (Rev. 11/ 71 )                                                                                        Page 2 of 3

                                                    Notice of Change
                                     33 South State Street, Chicago, Illinois 60603 
                                     Phone: 800-247-4984  |  Fax : 217-557-1948

E. Is the Illinois business still owned, managed or controlled in any way by the same interests that owned, managed or
controlled  the former business?                Yes          No
F. Did the new owner acquire all of the Illinois operations?          Yes           No
If No, what is the percentage acquired by the new entity?                 %
Percent of operations retained by you                          %
G. Is the new owner employing all of the same people that you did on the last day of business?       Yes      No
          If No, how many people were employed by you?
          How many of them does the new owner employ?
H. Did the new owner acquire any of your assets?               Yes        No          If yes, what %?
Percent of assets retained by you                                %
I. Did the new owner acquire any of your Illinois trade or business?      Yes         No       If yes, what %?
J. What was your trade or business ?
K. Is the new owner conducting the Illinois business which the new owner acquired?       Yes         No
If No, are you conducting the business?                      Yes        No
If neither you nor the new owner, who is conducting the business?         Name
Address                                                                               Phone Number
L. Is this business a franchise?                Yes          No
If Yes, were you the 
                           Franchisee or the                 Franchisor?

CERTIFICATION: I HEREBY CERTIFY THAT THE FOREGOING INFORMATION AND THAT CONTAINED IN ANY ATTACHED 
SHEETS SIGNED BY ME IS TRUE AND CORRECT. THIS REPORT MUST BE SIGNED BY OWNER, PARTNER, OFFICER OR 
AUTHORIZED AGENT WITHIN THE EMPLOYING ENTERPRISE. IF SIGNED BY ANY OTHER PERSON, A POWER OF 
ATTORNEY MUST BE ON FILE.

BUSINESS NAME                                                    DATE SIGNED AND SUBMITTED

SIGNED BY                                                        TITLE
HOME ADDRESS OF OFFICIAL
HOME TELEPHONE NUMBER    (          )

This state agency is requesting information that is necessary to accomplish the statutory purpose as outlined under 820 ILCS 
405/100-3200. Disclosure of this information is Required. Failure to disclose this information may result in statutorily prescribed 
liability and sanction, including penalties and/or interest. 

UI-50A (Rev. 11 7/1 )                                                                                    Page 3 of 3