Form UC-6 (Rev. 9/12)
ALABAMA DEPARTMENT OF LABOR
UNEMPLOYMENT COMPENSATION DIVISION
APPLICATION FOR VOLUNTARY ELECTION TO BECOME AN EMPLOYER UNDER THE ALABAMA
UNEMPLOYMENT COMPENSATION LAW
Commissioner of Department of Labor
649 Monroe Street
Montgomery, AL 36131
Dear Sir:
The undersigned, ________________________________________________________________of
_________________________________________________, being an employing unit under the
Alabama Unemployment Compensation Law, but not being and employer subject thereto, does hereby voluntarily elect pursuant to the terms and provisions of Section 25-4-131, Code of Alabama, 1975, as amended (Alabama Unemployment Compensation Law), to become as of the _________ day of
________, 20__, an “employer” fully subject to the Law, to the same extent as any other “employer”,
and hereby makes application for the written approval of such election. Dated this ________day of _______________, 20____.
Firm Name: _____________________________________________________________
By: ______________________________(Title)___________________________
By: ______________________________(Title)___________________________
By: ______________________________(Title)___________________________
Give two (2) references, one being, preferably, a banking institution.
_____________________________________________ |
________________________________ |
(Name) |
(Address) |
_____________________________________________ |
________________________________ |
(Name) |
(Address) |
|
|
Approved by the Commissioner of Alabama Department of Labor as of ___________________, 20____.
______________________________________
Commissioner |
|
By: ___________________________________________ |
____________________, 20____. |