Colorado Department of Labor and Employment

Form UITL-39: Employee Leasing Company Annual Report and Certification

$500

The application must be reviewed and signed by an independent counsel.

• Employee Leasing Company Sample Spreadsheet of Work-site Employers and Employees (needed only if more space is needed than is provided on the application)
• One of the following requirements must be met:
  • Execute and file a surety bond, letter of credit, or cash escrow equal to 50 percent of the total UI premiums assessed during the previous calendar year. The initial security amount for a new employee-leasing company is equal to the standard UI rate (.0170) multiplied by 50 percent of its projected chargeable payroll for the current calendar year as estimated by the employee-leasing company.
  • Submit the most recent independently audited financial statement prepared by a certified public accountant using generally accepted accounting principles, which demonstrates that you have an accounting working capital of not less than $100,000. The financial statement must be no older than 13 months.
  • Receive and provide an annual accreditation by a qualified, bonded, and independent assurance organization as approved by the Colorado Department of Labor and Employment.
• List of owners and/or officers including title and % of ownership or interest
• Work-site employer names and your percentage of ownership or interest if sharing ownership or interest with any work-site employers
• Work-site employer names and officer names and titles if the employee-leasing company and any work-site employer have common officers of a corporation
• Names and job titles of the family members and the name of the business the family member operates if the employee-leasing company and any of the work-site employers operated in whole or in part by related family members of either the employee-leasing company or work-site employers

Form UITL-39: Employee Leasing Company Annual Report and Certification

$500

Annually by June 30.

The application must be reviewed and signed by an independent counsel.

• Employee Leasing Company Sample Spreadsheet of Work-site Employers and Employees (needed only if more space is needed than is provided on the application)
• One of the following requirements must be met:
  • Execute and file a surety bond, letter of credit, or cash escrow equal to 50 percent of the total UI premiums assessed during the previous calendar year. The initial security amount for a new employee-leasing company is equal to the standard UI rate (.0170) multiplied by 50 percent of its projected chargeable payroll for the current calendar year as estimated by the employee-leasing company.
  • Submit the most recent independently audited financial statement prepared by a certified public accountant using generally accepted accounting principles, which demonstrates that you have an accounting working capital of not less than $100,000. The financial statement must be no older than 13 months.
  • Receive and provide an annual accreditation by a qualified, bonded, and independent assurance organization as approved by the Colorado Department of Labor and Employment.
• List of owners and/or officers including title and % of ownership or interest
• Work-site employer names and your percentage of ownership or interest if sharing ownership or interest with any work-site employers
• Work-site employer names and officer names and titles if the employee-leasing company and any work-site employer have common officers of a corporation
• Names and job titles of the family members and the name of the business the family member operates if the employee-leasing company and any of the work-site employers operated in whole or in part by related family members of either the employee-leasing company or work-site employers