TX-68B  
 
                                      (401) 574-8700  (option 1) 
                                          
                                      NOTICE OF ELECTION OF  
                  REIMBURSEMENT/CONTRIBUTION METHOD 
                                          
The  organization named hereon:  ____________________________________________ 
Name of Organization  
          
Address                               ____________________________________________                    
          
Please check one of the following and return with our Business Application and Registration form. 
 
Determination of Liability 
 
         Elects to reimburse the Rhode Island Employment Security Fund for Employment Security 
         benefits legally paid to individuals attributable to service in the employ of this organization  
            according to Sections 28-43-29,30,31 of the Rhode Island  Employment Security Act. 
 
         Elects to pay contributions under the provisions of Chapters 42 to 44, inclusive, of the Rhode 
         Island Employment Security Act. 
 
Signed________________________________Title________________________Date_____________ 

                           1511 Pontiac Avenue, Cranston, RI 02920-0942 
                           Tel. (401) 574-8700 Fax (401) 574-8940 TTY Relay via 711 
                                      https://dlt.ri.gov/employers/employer-tax-unit