Massachusetts Department of Labor Standards - Professional Employer Organization Program

Application for Professional Employer Organization (PEO) Certificate of Registration

$500

• Name(s) under which the PEO conducts business or will conduct business
• Address of each office the PEO maintains in Massachusetts
• A list of all mailing addresses of the PEO
• Statement of ownership for the President and Treasurer if a corporation or for each partner that owns at least 25% of the equity interest of the PEO if a partnership, LP, or LLP

If you are filing without an assurance by an independent and qualified assurance organization the following must also be filed:

• A financial statement setting forth the financial condition of the PEO or PEO Group, which shall include the most recent audit of the applicant that shall not be more than 13 months old. The financial statement shall be prepared in accordance with generally accepted accounting principles and the audit shall be conducted by an independent certified public accountant licensed to practice in the jurisdiction in which such accountant is located.
• A copy of the registrants’ standard comprehensive PEO agreement to be used by the PEO
• A client list, including the client name, physical address, telephone number, and federal identification number for whom the PEO is providing professional employer services
• A statement of management for the preceding 5 years, which shall include the name and evidence of business experience of any person who serves or will serve, if known, or reasonably known at time of registration, as President, Chief Executive Officer, or otherwise as the authority to act as Senior Executive Officer of the PEO
• A list by jurisdiction of each name under which the PEO has operated in the preceding 5 years, including any alternative names, names of predecessors and successor business entities
• An Affirmation of Workers Compensation Insurance
• A surety bond filed in the penal sum of $250,000 payable to, “the People of the Commonwealth,” reflecting the address of the PEO office on the bond certificate

Renewal Application for Professional Employer Organization (PEO) Certificate of Registration

$500

Annually by the date of issuance.

• Changes to the name(s) under which the PEO conducts business or will conduct business
• Changes to the address of any office the PEO maintains in Massachusetts
• Changes to the mailing addresses of the PEO
• Changes to the statement of ownership

If you are filing without an assurance by an independent and qualified assurance organization the following must also be filed:

• A financial statement setting forth the financial condition of the PEO or PEO Group, which shall include the most recent audit of the applicant that shall not be more than 13 months old. The financial statement shall be prepared in accordance with generally accepted accounting principles and the audit shall be conducted by an independent certified public accountant licensed to practice in the jurisdiction in which such accountant is located.
• A copy of the registrants’ standard comprehensive PEO agreement to be used by the PEO
• Changes to the client list, including the client name, physical address, telephone number, and federal identification number for whom the PEO is providing professional employer services
• Changes to the statement of management for the preceding 5 years, which shall include the name and evidence of business experience of any person who serves or will serve, if known, or reasonably known at time of registration, as President, Chief Executive Officer, or otherwise as the authority to act as Senior Executive Officer of the PEO
• Changes to the list by jurisdiction of each name under which the PEO has operated in the preceding 5 years, including any alternative names, names of predecessors and successor business entities
• An Affirmation of Workers Compensation Insurance
• A surety bond filed in the penal sum of $250,000 payable to, “the People of the Commonwealth,” reflecting the address of the PEO office on the bond certificate

$0

Within 30 days after the address is changed.

454 CMR 30.08

PEOs seeking to change their address must notify the department in writing of their new address. Supporting documentation and or a site visit may be required by the department to verify the change of address.