Colorado Department of Labor and Employment, Unemployment Insurance Employer Services 
                                                  P.O. Box 8789, Denver, CO 80201-8789 
                     Phone 303-318-9100 (Denver-metro area) or 1-800-480-8299 (outside Denver-metro area); Fax 303-318-9206 
                                                        www.colorado.gov/cdle/ui 
                                                                       
                                         REQUEST  FOR  SEASONAL  STATUS 

 Fill out this form to request to be a seasonal employer for unemployment purposes.  Send it to the address or fax number at the top of 
 the form.  Seasonal means that your whole business or occupations within your business work less than 26 weeks in a calendar year.  
 The time includes Saturdays and Sundays.  We use the law to make our decision on whether you can be a seasonal employer.  We must 
 decide if you can be a seasonal employer for all of your business or for occupations within your business.  See the Colorado 
 Employment Security Act 8-73-106 and the Regulations Concerning Employment Security Part X.  We must tell you that you are a 
 seasonal employer before your season begins.  If we have not told you before the season begins, you must wait until the start of your 
 next season to be a seasonal employer. 
 Your Company’s Legal Name (Your legal company name as listed with the Secretary of State)         Your Employer Account Number 
  
 Your Trade Name (DBA)                                                                             Telephone Number 

 Company’s Street Address                                        City                              State              ZIP Code 

                         Fill out this section if your mailing address is different from what you wrote above. 
 In Care of Name 

 Mailing Address                                                 City                              State              ZIP Code 

 REQUIREMENTS 
 To be a seasonal employer, you must meet these requirements: 
    •    All your workers in your entire business or in each seasonal occupation must work less than 26 weeks in a calendar year. 
    •    You must have at least 45 days in a row in a calendar year during which the workers do not work in the seasonal occupation. 
    •    Not more than 25 percent of all the workers in your entire business or in each seasonal occupation can work outside the 
         season. 
 INSTRUCTIONS 
 If you want your entire business operation to be seasonal, fill out only Items 1 and 2.  Turn the form over and sign it.  
 If you want some occupations within your business to be seasonal, fill out the whole form.  Remember to sign the back. 
 Please type all dates as mm/dd/yyyy. 

 1.  In what calendar year do you want to be a seasonal employer?         ___________________________ 
 2.  Does your entire business work for less than 26 weeks during the calendar year? 
         Yes.     List your business’s first and last dates for your seasonal periods.  If you have more than one seasonal  period, 
         list the first and last days for each season.  
         First date for the first season    ________________________________________ 
         Last date for the first season     ________________________________________ 

         First date for the second season (if you have one)      ________________________________________ 
         Last date for the second season (if you have one)       ________________________________________ 

         No.  Fill out Items  3and 4. 
IMPORTANT!  This document(s) contains important information about your unemployment compensation rights, responsibilities and/or benefits.  It is critical that you 
understand the information in this document.  If needed, call 303-318-9100 for assistance in the translation and understanding of the information in the document(s) you 
have received.   
 
¡IMPORTANTE!  Este documento(s) contiene información importante sobre sus derechos, obligaciones y/o beneficios de compensación por desempleo.  Es muy 
importante que usted entienda la información contenida en este documento.  Si necesita asistencia para traducir y entender la información contenida en el documento(s) 
que recibió, llame al 303-318-9100.  

  UITL-5 (R 02/2012) 

                                   OCCUPATIONS  WITHIN  YOUR  BUSINESS 
Within your business, you may have more than one occupation.  Workers in each of those occupations perform different 
work from workers in other occupations.  You may request seasonal status for one or more of those occupations. 
For each occupation, we need to know that: 
    •     All workers in the occupation work less than 26 weeks in a calendar year. 
    •     You have at least 45 days in a row during which the workers do not work in the seasonal occupation. 
    •     Not more than 25 percent of all workers in the occupation work outside the season. 
Please figure out if each occupation meets all three requirements.  If an occupation meets all three requirements, please fill 
out Item 3.  If an occupation does not meet all requirements, please fill out Item  .4
If you do not have enough room to list all seasonal occupations on this form, you may photocopy this page to list more 
occupations.  You may also send us a typed spreadsheet with the information. 
 
3.  Fill out this section for all occupations that meet all the seasonal requirements (less than 26 weeks; 45 days between 
    seasons; no more than 25 percent of workers working outside the season).  
    •     Title:  Fill in the name of each occupation. 
    •     Seasonal Periods:  Fill in the first and last dates of the occupation’s season.  Also fill in the total number of 
          seasonal workers you will have during that season.  Remember that you may have more than one season.  List 
          each season separately. 
    •     Nonseasonal Periods:  Fill in the first and last dates of the occupation’s off-season.  Also fill in the total number 
          of workers you will have during that time.  Remember that no more than 25 percent of the workers in the 
          occupation can work during the off-season.  If more than 25 percent work during the off-season, list that 
          occupation Item 4. 
                                              Seasonal Periods                                   Nonseasonal Period 
                                                               Number of                                            Number of 
             Title                 First Date   Last Date              Workers        First Date Last Date          Workers 
                                    
4.  Fill out this section if one or more of your occupations do not meet all the seasonal requirements (less than 26 weeks; 45 
 days between seasons; no more than 25 percent of workers working outside the season).  Tell us about all occupations 
 that are not in Item 3. 
      •      Title:  Fill in the name of each occupation. 
      •      Job Duties:  Describe what the workers do. 
Title Job Duties 
  
The information provided is true, correct, and complete to the best of my knowledge and belief.  I understand there are 
severe penalties, including fines and jail, for not telling the truth. 
Signature                                                                                        Date 
 
UITL-5 Reverse (R 12/2010)