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Mail To: This form can be completed online at
Cashier - Texas Workforce Commission www.texasworkforce.org
P.O. Box 149037
Austin, TX 78714-9037
512.463.2731
NOTICE THAT EMPLOYMENT OR BUSINESS HAS BEEN DISCONTINUED
(STATUS CHANGE)
Account Number _________________________________
NOTICE IS HEREBY GIVEN to the Texas Workforce Commission that the employer named in Item No. 1 below
has suspended or discontinued employment in Texas; and that the employer will not file quarterly contribution and wage
reports for periods after the date shown in Item No. 4 below, if applicable, until such time in the future as the employer
again has one or more persons in employment under the Texas Unemployment Compensation Act.
1. EMPLOYER NAME:
2. PRESENT MAILING ADDRESS:
3. Last date on which any person performed employment for this employer:
4. Date of payment of final wages for any employment through the date shown in Item 3:
5. REASON FOR DISCONTINUATION OF EMPLOYMENT: If a partial acquisition occurred, the predecessor/successor
may jointly submit information regarding a partial transfer of experience.
Business in Texas suspended or discontinued entirely, without a successor…………………… DATE:
Business in Texas continued in operation without employment after the date shown in Item 3 DATE:
Business in Texas acquired by a successor………………………………………………………… DATE:
6. NAME AND ADDRESS OF THE SUCCESSOR:
7. Did the successor acquire all of your assets or business in Texas? YES NO If the answer is “NO”
explain what part of your assets or business the successor acquired and what part you retained.
AUTHORIZED CHANGES FOR EMPLOYER
(for TWC use only)
IMPORTANT WARNING:
The filing of this notice does not have the effect of changing th
1 ___________________________________________________________
employer’s status as a subject “employer” under Chapter 201,
2 ___________________________________________________________ Subchapter C of the Texas Unemployment Compensation Act
and does not terminate liability. After filing this notice, the
3. ___________________________________________________________ employer
will continue to be liable for the payment of contributions on
4. _____________________________________________________
wages paid for any employment that the employer may have in
5. _____________________________________________________ the future — regardless of the number of employees. This
notice will relieve
6. _____________________________________________________ the employer of only the duty of filing quarterly contributions
(New) County Code _______ Tax Area_______ and wage reports for periods during which no employment is
performed. The employer’s liable status as a subject
“employer” may be terminated only as of the beginning of a
----------------------------------------------------------------------------------- calendar year and only in accordance with the provisions of
Section 206.004 of the Act which is is quoted on the back side
Authority: _____________________________________________ of this form.
FROM: ACCTS. EXAMINER ______________________________ SIGNATURE: ___________________________________________________
TAX AREA __________________ DATE____________________ TITLE: _________________________________________________
DATE:_ __________________________________________________
C-13 (082015) (SEE EXCERPTS FROM THE LAW PRINTED ON PAGE 2 OF THIS FORM)
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