Homepage Blank Texas Vtdlr Sls 017 Form
Outline

The Texas Vtdlr Sls 017 form is a crucial document for businesses seeking a limited license to operate as staff leasing services companies in Texas. This form requires detailed information about the business, including its name, ownership structure, and physical and mailing addresses. Applicants must provide their Federal ID number and indicate whether the company employs fewer than 50 assigned employees in Texas or solicits clients based in the state. A significant requirement is the submission of an audited financial statement demonstrating positive working capital, which varies based on the number of employees assigned. Additionally, the form mandates the inclusion of a Texas Secretary of State document that recognizes the business entity, ensuring compliance with state regulations. Other essential components include contact information for a designated representative, insurance details, and a certification statement that affirms the accuracy of the provided information. Completing this form accurately and submitting all required attachments is vital for obtaining the necessary licensing to operate legally in Texas.

Sample - Texas Vtdlr Sls 017 Form

TEXAS DEPARTMENT OF LICENSING AND REGULATION

P. O. Box 12157 • Austin, Texas 78711 • (800) 803-9202 • Fax (512) 463-5984

E-mail: [email protected] Web site: www.license.state.tx.us

FEE

RECEIPT NUMBER

PMT.

MONEY

AMOUNT

TYPE

 

 

$900

DO NOT WRITE IN THE FEE AREA IMMEDIATELY ABOVE

Staff Leasing Services Application: New Limited License

Company Information

1.Name of Business to be Licensed :_________________________________________________________

DBA (if applicable):_______________________________________________________________________

2.Federal ID Number (FEIN):__________________________________________________________________

3.Please indicate the type of ownership for this company:

Corporate

Partnership

Individual

Limited Liability Company

4. Business Physical Address:________________________________________________________________

 

 

 

NUMBER AND STREET

 

 

__________________________________________________________________________________________________________

 

CITY

 

STATE

ZIP

5.Business Mailing Address: ________________________________________________________________

NUMBER AND STREET OR PO BOX

___________________________________________________________________________________________________________

CITY

STATE

ZIP

6.Business Phone:__________________________________ 7. Business Fax:________________________

8.Please answer the following questions:

[ ] Yes [ ] No

Does this company employ fewer than 50 assigned employees in Texas at one time?

[

] Yes

[

]

No

Does this company assign employees to any client company based or domiciled in Texas?

[

] Yes

[

]

No

Does this company solicit client companies located or domiciled in Texas?

[

] Yes

[

]

No

Does this company maintain an office in Texas?

[

] Yes

[

]

No

Is this company licensed or registered as a staff leasing services company in the state

 

 

 

 

 

where domiciled? (If yes, attach a copy of license or registration).

_____________

Number of employees assigned in Texas.

_____________

State where company is domiciled.

Contact Information

9.Contact person: _________________________________________________ Title:______________________

10.Contact e-mail:______________________________ 11. Contact phone:_____________________________

12.Texas Secretary of State Document - An application for a new license must include a copy of a document from the Texas Secretary of State that recognizes the business entity. This document must be issued in exactly the same business name as the applicant for this license and can be in the form of a Certificate of Authority or Certificate of Incorporation. Contact the Texas Secretary of State’s office at (512)463-5555 or at www.sos.state.tx.us for more information. Please enclose this document with your application.

YOU MUST COMPLETE ALL OF THE INFORMATION REQUESTED ON THIS FORM AND ALL OF THE REQUIRED ATTACHMENTS. PLEASE CONTINUE TO PAGE 2.

TDLR Form SLS 017 (12/2011)

Page 1 of 3

13. Working Capital Requirements

Pursuant to House Bill 2249 (81st Legislature, 2009) effective December 31, 2011, all Staff Leasing Services companies must submit an audited financial statement that shows positive working capital. Please enclose your most recent audited financial statement with this application.

“Working capital” of an applicant means the applicant’s current assets minus the applicant’s current liabilities as determined by generally accepted accounting principles. An applicant for an original or renewal license must demonstrate positive working capital in the following amounts:

(1)$50,000 if the applicant employs fewer than 250 assigned employees;

(2)$75,000 if the applicant employs at least 250 but not more than 750 assigned employees; and

(3)$100,000 if the applicant employs more than 750 assigned employees.

The audited financial statement must be prepared in accordance with generally accepted accounting principles, be audited by an independent certified public accountant, and be without qualification as to the going concern status of the applicant.

Please note: surety bonds, letters of credit, or guarantees ALONE are no longer accepted as proof of positive working capital. You MUST submit an audited financial statement for the company named on this application. Any deficiencies in the working capital requirement may be satisfied through guarantees, letters of credit, a surety bond or other security acceptable to TDLR, provided they are accompanied by the company’s audited financial statement. For more information on working capital requirements, please see our website: www.license.state.tx.us/sls/sls.htm or call us at (800) 803-9202.

14. Controlling Persons and/or Corporations

FORMS ARE AVAILABLE AT OUR WEBSITE: www.license.state.tx.us/sls/slsforms.htm

Please submit a Controlling Person Personal Information Form for each Controlling Person of your company.

Please submit a Controlling Corporation Information Form, if applicable.

15. Additional Attachments & Information

WORKER’S COMPENSATION CERTIFICATE OF INSURANCE: Please enclose a certificate of insurance if you offer worker’s comp insurance to employees assigned in Texas. Insurers must be authorized by Texas Dept. of Insurance. INSURANCE INFORMATION FORM: Please complete the enclosed Insurance Information Form (page 3) for all other types of insurance offered to employees assigned in Texas, if applicable. Do not submit certificates or booklets for other types of insurance (health, disability, life, etc.).

DESIGNATED AGENT FOR SERVICE: Please provide the following information for your agent for service in Texas:

________________________________________________________________(________)__________ - ___________

Agent Name

 

Agent Phone

_______________________________________________________________________________________________________TX_______________

Agent Address

City

ZIP

16. Authorized Signature

I certify that I have read the Staff Leasing Services Act, Title 2, Labor Code, Subtitle E, and the current Department of Licensing and Regulation rules. If the license is issued, I agree to furnish to the Department of Licensing and Regulation any change in information on this form and all attached documents within FORTY-FIVE (45) DAYS of the change.

Licensure is subject to revocation if the department is not notified, in writing, of any changes in the information given on this application or if there is a rule or law violation.

I certify that all information submitted on this application and on all attached documents is true and correct.

__________________________________________________________________________________________________________

Authorized Representative’s SignatureDate

__________________________________________________________________________________________________________

Authorized Representative’s Printed Name

Date

PLEASE CONTINUE TO PAGE 3.

Page 2 of 3

17. Insurance Information Form

Please list all types of insurance coverage offered to employees assigned in Texas. Insurers must be authorized by the Texas Department of Insurance. If you offer worker’s comp insurance, please enclose the Certificate of Insurance in addition to listing it below. Do not submit any other type of certificate of insurance, booklet, or paperwork for any other type of insurance except worker’s comp.

Be advised that “self-insurance” health benefit plans are not allowed except as described in the Staff Leasing Services Labor Code:

Sec. 91.043. Health Benefit Plans.

(a)A license holder may not sponsor a plan of self insurance for health benefits except as permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).

(b)For purposes of this section, a "plan of self insurance" includes any arrangement except an arrangement under which an insurance carrier authorized to do business in this state has issued an insurance policy that covers all of the obligations of the health benefits plan.

If you are using any plan which is not fully insured, you will be required to submit an opinion from the U.S. Dept. of Labor that states your insurance plan is permitted by the Employee Retirement Income Security Act (ERISA).

Are you currently providing a plan which is NOT fully insured?

NO

YES

NAME OF INSURER

TYPE OF COVERAGE

EFF. DATE

EXP. DATE

POLICY NUMBER

__________________________________

_________________

_________

_________

_____________________

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Please submit this completed application, any attachments and the appropriate fees to the address at the top of page 1. For additional forms and information, please visit our website at: www.license.state.tx.us/sls/sls.htm

Page 3 of 3

Form Information

Fact Name Description
Governing Law The Texas Staff Leasing Services Act, Title 2, Labor Code, Subtitle E governs the application process for the SLS 017 form.
Application Fee A fee of $900 is required when submitting the SLS 017 form.
Ownership Types Applicants must indicate their ownership type, which can be Corporate, Partnership, Individual, or Limited Liability Company.
Working Capital Requirements Applicants must demonstrate positive working capital, with amounts varying based on the number of employees assigned in Texas.
Contact Information Each application must include a designated contact person, along with their title, email, and phone number.
Insurance Requirements Applicants must provide a Worker’s Compensation Certificate of Insurance if applicable, along with other insurance information as required.

Detailed Guide for Filling Out Texas Vtdlr Sls 017

Completing the Texas VTDLR SLS 017 form requires careful attention to detail. This form is essential for applying for a new limited license for staff leasing services in Texas. Below are the steps to guide you through the process of filling out the form accurately.

  1. Begin by entering the Name of Business to be Licensed in the first blank line.
  2. If applicable, provide the DBA (Doing Business As) name in the next line.
  3. Fill in the Federal ID Number (FEIN) in the designated space.
  4. Select the type of ownership for your company by checking one of the options: Corporate, Partnership, Individual, or Limited Liability Company.
  5. Enter the Business Physical Address, including the street number, city, state, and ZIP code.
  6. Provide the Business Mailing Address, which can be a street address or P.O. Box, along with the city, state, and ZIP code.
  7. Input the Business Phone number and the Business Fax number.
  8. Answer the following questions by marking "Yes" or "No" for each:
    • Does this company employ fewer than 50 assigned employees in Texas at one time?
    • Does this company assign employees to any client company based or domiciled in Texas?
    • Does this company solicit client companies located or domiciled in Texas?
    • Does this company maintain an office in Texas?
    • Is this company licensed or registered as a staff leasing services company in the state where domiciled?
  9. Indicate the Number of employees assigned in Texas and the State where the company is domiciled.
  10. Provide the Contact person name and Title.
  11. Fill in the Contact e-mail and Contact phone number.
  12. Attach a copy of the document from the Texas Secretary of State that recognizes the business entity.
  13. Include an audited financial statement that shows positive working capital.
  14. Submit a Controlling Person Personal Information Form for each controlling person of the company.
  15. If applicable, submit a Controlling Corporation Information Form.
  16. Attach a Worker’s Compensation Certificate of Insurance if applicable.
  17. Complete and attach the Insurance Information Form for other types of insurance offered to employees assigned in Texas.
  18. Provide the information for your Designated Agent for Service in Texas, including their name, phone number, and address.
  19. Finally, ensure the Authorized Signature is completed, along with the date and printed name of the authorized representative.

Once the form is completed, gather all attachments and submit them to the address listed at the top of the first page. For further assistance or additional forms, refer to the Texas Department of Licensing and Regulation website.

Obtain Answers on Texas Vtdlr Sls 017

  1. What is the purpose of the Texas VTDLR SLS 017 form?

    The Texas VTDLR SLS 017 form is used to apply for a new limited license for staff leasing services in Texas. This form gathers essential information about the business, including ownership type, business addresses, contact details, and compliance with state regulations. Completing this form accurately is crucial for obtaining the necessary licensing to operate legally in Texas.

  2. What information is required to complete the form?

    To complete the Texas VTDLR SLS 017 form, you will need to provide:

    • Name of the business and any DBA (Doing Business As) name.
    • Federal ID Number (FEIN).
    • Type of ownership (e.g., corporate, partnership, individual).
    • Business physical and mailing addresses.
    • Contact person’s details, including name, title, email, and phone number.
    • Answers to specific questions regarding employee assignments and office locations in Texas.

    Additionally, you must submit a copy of your Texas Secretary of State document and an audited financial statement showing positive working capital.

  3. What are the working capital requirements for the application?

    Working capital requirements vary based on the number of employees assigned:

    • $50,000 for fewer than 250 employees.
    • $75,000 for 250 to 750 employees.
    • $100,000 for more than 750 employees.

    It is important to note that the audited financial statement must be prepared according to generally accepted accounting principles and audited by a certified public accountant. Surety bonds or letters of credit alone are not sufficient proof of working capital.

  4. How can I submit the completed application?

    You can submit the completed Texas VTDLR SLS 017 form, along with any required attachments and fees, to the address provided at the top of the form. Ensure that all information is accurate and complete to avoid delays in processing. For further assistance or additional forms, visit the Texas Department of Licensing and Regulation website.

Common mistakes

Filling out the Texas VTDLR SLS 017 form can be straightforward, but many applicants make common mistakes that can delay the licensing process. One frequent error is leaving the business name section incomplete or incorrect. Ensure that the name matches exactly with what is registered with the Texas Secretary of State. Any discrepancies can lead to rejection of the application.

Another common mistake involves the Federal ID Number (FEIN). Applicants sometimes enter an incorrect number or omit it entirely. This number is crucial for identification and tax purposes, so double-check to make sure it is accurate and complete.

Many applicants fail to indicate the type of ownership for their business. Selecting the appropriate ownership type is essential, as it affects the legal and financial responsibilities of the business. Be sure to check the correct box and provide any necessary documentation that supports your choice.

Providing an incomplete business address is another mistake that can lead to complications. Both the physical and mailing addresses must be filled out completely, including the city, state, and ZIP code. Missing information can result in delays in communication from the licensing authority.

In the section regarding the number of employees, applicants often either miscalculate or leave this section blank. This information is vital for determining the company’s compliance with state regulations. Make sure to provide an accurate count of employees assigned in Texas.

Some applicants neglect to include the required audited financial statement. This document must demonstrate positive working capital and must be prepared according to generally accepted accounting principles. Failure to submit this statement can result in immediate disqualification of the application.

Additionally, applicants may forget to attach the Worker’s Compensation Certificate of Insurance if applicable. This certificate is necessary if the company offers worker’s compensation insurance. Ensure that it is included with the application to avoid processing delays.

Inaccurate or missing information regarding the designated agent for service can also cause issues. This section requires specific details about the agent, including their name, phone number, and address. Omitting any of this information can lead to complications in legal notifications.

Lastly, many applicants overlook the authorized signature section. This signature confirms that the applicant has read and understood the Staff Leasing Services Act. An unsigned application will not be processed, so ensure that the authorized representative signs and dates the form before submission.

Documents used along the form

The Texas Vtdlr Sls 017 form is a key document for businesses seeking a staff leasing services license in Texas. Along with this form, several other documents are commonly required to ensure compliance with state regulations. Below is a list of these documents, along with a brief description of each.

  • Texas Secretary of State Document: This document verifies the business entity and must match the name on the application. It can be a Certificate of Authority or Certificate of Incorporation.
  • Audited Financial Statement: Required to demonstrate positive working capital, this statement must be prepared by an independent certified public accountant and comply with generally accepted accounting principles.
  • Controlling Person Personal Information Form: This form is necessary for each individual who has significant control over the company. It collects personal details to ensure transparency and compliance.
  • Controlling Corporation Information Form: If applicable, this form provides information about any corporations that control the business applying for the license.
  • Worker’s Compensation Certificate of Insurance: If the business offers worker’s compensation insurance, a certificate from an authorized insurer must be included with the application.
  • Insurance Information Form: This form lists all types of insurance coverage offered to employees, excluding worker’s compensation, which requires its own certificate.
  • Designated Agent for Service Information: This document provides the contact details for the agent designated to receive legal documents on behalf of the business in Texas.
  • Authorized Signature Section: This section of the application must be signed by an authorized representative, confirming that all information provided is accurate and complete.
  • Additional Attachments: Any other relevant documents that support the application may also be required, depending on the specific circumstances of the business.

Submitting these documents along with the Texas Vtdlr Sls 017 form is crucial for a successful application process. Ensuring all required materials are included will facilitate a smoother review by the Texas Department of Licensing and Regulation.

Similar forms

  • Texas Secretary of State Document: This document is required for business recognition and must match the business name on the application. It can be a Certificate of Authority or Certificate of Incorporation.
  • Audited Financial Statement: Similar to the SLS 017 form, this document demonstrates positive working capital, showing the company's financial health through an independent audit.
  • Controlling Person Personal Information Form: This form collects personal information about individuals who control the company, ensuring transparency in business operations.
  • Controlling Corporation Information Form: If applicable, this document provides details about any corporations that control the applicant, similar to the personal information form.
  • Worker’s Compensation Certificate of Insurance: This certificate verifies that the company provides worker's compensation insurance, a critical aspect of employee safety and compliance.
  • Insurance Information Form: This form outlines all types of insurance coverage provided to employees, ensuring that the company meets legal requirements for various insurances.
  • Designated Agent for Service Information: This document identifies the agent responsible for receiving legal documents on behalf of the company, ensuring proper communication with regulatory authorities.
  • Application for Business License: Like the SLS 017 form, this application is essential for obtaining a business license, requiring similar business and ownership information.
  • Financial Disclosure Forms: These forms may be required to disclose financial information for transparency and regulatory compliance, similar to the audited financial statement.
  • Employee Count Documentation: This document provides information on the number of employees assigned in Texas, which is crucial for determining licensing requirements.

Dos and Don'ts

When filling out the Texas VTDLR SLS 017 form, it’s crucial to follow specific guidelines to ensure a smooth application process. Here are four key do's and don'ts to keep in mind:

  • Do ensure all sections of the form are filled out completely. Missing information can delay your application.
  • Do attach all required documents, such as the audited financial statement and the Texas Secretary of State document. This is essential for your application to be considered.
  • Don't write in the fee area. The form specifies not to write anything in that section, so be sure to adhere to this instruction.
  • Don't submit any certificates or booklets for insurance types other than worker’s compensation. Only the Certificate of Insurance for worker’s comp should be included.

By following these guidelines, you can help ensure that your application is processed efficiently and without unnecessary complications.

Misconceptions

Understanding the Texas VTDLR SLS 017 form can be challenging, and several misconceptions can lead to confusion. Here are five common misunderstandings regarding this form:

  • The form is only for large companies. Many believe that only large businesses need to fill out this form. In reality, any company that provides staff leasing services in Texas, regardless of size, must complete the application.
  • All types of insurance must be submitted with the application. Some applicants think they need to provide certificates for all types of insurance. However, only the worker’s compensation certificate is required at the time of application.
  • Positive working capital can be proven with surety bonds alone. It is a common misconception that surety bonds or letters of credit are sufficient to demonstrate positive working capital. The form explicitly states that an audited financial statement is necessary for this purpose.
  • Changes in company information do not need to be reported. Some individuals believe that once the application is submitted, they do not have to report changes. This is incorrect; any changes must be reported within 45 days to avoid potential revocation of the license.
  • The application process is quick and straightforward. Many applicants underestimate the complexity of the process. The application requires careful attention to detail and the inclusion of several documents, which can take time to prepare.

Key takeaways

  • Complete All Sections: Make sure to fill out every section of the Texas VTDLR SLS 017 form. Incomplete applications can lead to delays or denials.

  • Financial Documentation: Submit an audited financial statement showing positive working capital. This is crucial for demonstrating your company's financial health and compliance.

  • Ownership Type Matters: Clearly indicate your business's ownership type, whether it's a corporation, partnership, or LLC. This information is essential for proper classification.

  • Attach Required Documents: Don't forget to include necessary attachments, such as a copy of your Texas Secretary of State document and worker’s compensation insurance certificate if applicable.

  • Stay Updated: Keep the Texas Department of Licensing and Regulation informed of any changes to your business information within 45 days. Failing to do so can result in license revocation.