PDF document

- 1 -

Notification of Business
Acquisition/Merger or Purchase/Sale

Have questions? Need assistance? DEW is here to help!
Call 803-737-2400, and listen to the options to reach a customer service representative.
Remember, you can access information and request services by visiting DEW’s Website at www.dew.sc.gov

Use this form to notify DEW when succeeding, in whole or in part, another in the operation of a business.
Pursuant to S.C. Regs. 47-17) an employer that succeeds another employer in the operation of a business, in whole or in part,
must notify DEW of the succession.

Whenever one employer succeeds another employer in the operation of a business, in whole or in part, DEW requires
information on the succession to calculate the experience rating of the succeeding employer.

If an employer purchases or acquires only a portion of the business, DEW may be required to transfer only that portion of the
former employer’s experience to the succeeding employer. DEW will inspect the former employer’s payroll and benefit records
to determine what should transfer to the successor for rate calculation purposes.

Notify DEW by following these steps:

1. Complete all sections of this form and provide as many details as possible to avoid unnecessary requests for additional
information;
2. Sign and date the form;
3. Mail the completed form to: SCDEW
Document Control
P.O. Box 995
Columbia, SC 29202

4. You may also update this form in your SUITS, Self-Service Portal at https://uitax.dew.sc.gov.

Section A - General information
Provide general information for the succeeding new employer and former employer. If you are the successor/new employer
and do not have an unemployment insurance tax account with DEW, you must complete registration by visiting DEW’s
online tax system, SUITS at Website at https://uitax.dew.sc.gov.

Section B - Transaction detail to be completed by the former employer
DEW uses the information provided in this section to determine if a succession has occurred. DEW evaluates criteria,
including but not limited to, the items listed below to make this determination.
• Business ownership
• Continuity of business operations
• Real estate, plant and equipment, material inventories and other real property
• Customer profiles
• Industrial pursuit
• Employee roster

Section C - Transaction detail to be completed by the new/successor employer
DEW uses the information provided in this section to determine if a succession has occurred. DEW evaluates criteria,
including but not limited to, the items listed below to make this determination.
• Business ownership
• Continuity of business operations
• Real estate, plant and equipment, material inventories and other real property
• Customer profiles
• Industrial pursuit

Section D - Certification
This section is where the parties associated with the transaction read the certification statement and provide their signatures.
However, DEW has the authority to proceed with processing the transaction without the signature or agreement of one or both
of the parties.

1 | P a g e

- 2 -

Section A - General information
If you do not have a South Carolina unemployment insurance tax account, you must you must complete registration by visiting DEW’s online
tax system, SUITS at Web site at https://uitax.dew.sc.gov

Former Business Owner - complete section A, C and D only
Legal business name DEW UI tax account number

Trade name or doing business as name (DBA) Telephone number

Current Business Owner - complete section A, B and D only
Legal business name DEW UI tax account number

Trade name or doing business as name (DBA) Telephone number

Section B - Transaction detail to be completed by the former employer
1. On what date did you sell the business? _______________________________________________________

2. If you are no longer operating in South Carolina, what was the date you last employed South Carolina employees? ___________________

3. Did you sell all or part of your business? If this is a partial acquisition or sale, of an existing business, explain what portion or
location of the entire operation was sold.
4. Is there a purchase/sale agreement associated with this transaction? Yes No
(DEW may request a copy of the purchase/sale agreement.)
5. Do you continue to operate any additional Ohio locations under this policy? Yes No

Explain:_______________________________________________________________________________________________________

__________________________________________________________________________________________________________ ____

6. Provide the names of all partners, corporate officers or individuals that have ownership interest for the former and succeeding employer.
Ownership interests for former employer Ownership interests for succeeding employer

7. Has the business been in continuous operation? Yes No

Explain:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________

8. Is the succeeding employer continuing to operate in the same location? Yes No

Explain:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________

9. How many employees did you have prior to the sale? ________________________

2 | P a g e

- 3 -

Section B - Transaction detail to be completed by the former employer (continued)

10. Did you sell any machinery or equipment to the successor?

Explain:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________
11. Did you sell any contracts or customers?

Explain:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________
12. Provide any additional information you believe pertinent to this transaction. (Attach additional information as needed)

______________________________________________________________________________________________________________

Section C - Transaction detail to be completed by the new/successor employer

1. What date did you acquire/purchase the business? ___________________________________________________

2. From whom did you acquire/purchase the business from? _____________________________________________

3. Is there a purchase/sale agreement associated with this transaction? Yes No
(If yes, DEW may request a copy of this agreement.)

4. Provide the names of all partners, corporate officers or individuals that have an ownership interest for the New/Successor and former
employer.
Ownership interests for former employer Ownership interests for succeeding employer

5. Did you acquire all or part of an existing business?
Please explain what was acquired or purchased. _______________________________________________________________________
______________________________________________________________________________________________________
6. Has the business been in continuous operation? n Yes n No
Explain:_______________________________________________________________________________________________________

______________________________________________________________________________________________________________

7. Are you operating in the former employer’s location? Yes No
Explain:_______________________________________________________________________________________________________
______________________________________________________________________________________________________________
8. How many employees of the former employer did you retain/hire? ___________________________
9. Did you acquire or purchase the former employer’s contacts or customers? Yes No
Explain:_______________________________________________________________________________________________________
______________________________________________________________________________________________________________
10. Will you conduct business in the same/similar manner as the former employer? Yes No
Explain:_______________________________________________________________________________________________________
______________________________________________________________________________________________________________
11. Did you acquire or purchase any machinery or equipment from the former employer? Yes No
Explain:_______________________________________________________________________________________________________
____________________________________________________________________________________________________________

3 | P a g e

- 4 -

 Section D - Certification 

 By my signature, I certify I have the authority to notify DEW of this transfer, and the facts set forth on this notification form are true and correct 
 to the best of my knowledge. I am aware that any person who misrepresents, conceals facts or makes false statements may be subject to civil, 
 criminal and/or administrative penalties. 
  
 If you are current business owner, sign here. 
  
  Signature of owner, partner, member or executive officer                                                                                 Title 
                                                                                                                                            
  Print name of above signature                                                                                                            Date 
                                                                                                                                            
  Telephone number                                                                                                                         Email 
  
 If you are the previous business owner, sign here. 
  
  Signature of owner, partner, member or executive officer                                                                                 Title 
                                                                                                                                            
  Print name of above signature                                                                                                            Date 
                                                                                                                                            
  Telephone number                                                                                                                         Email 

  DEW has the right to proceed with processing a transaction to transfer the former employers experience and the liabilities or credits when 
  the successor wholly succeeds another employer in the operation of a business without one or both of the parties’ signature or approval. 
 
                                                                                                                                                 4 | P a g e

PDF file checksum: 293240211

(Plugin #1/9.12/13.0)