The Texas Vtdlr Sls 017 form is an application required for businesses seeking a limited license for staff leasing services in Texas. This form collects essential information about the business, including ownership details and employee assignments, to ensure compliance with state regulations. Completing this form accurately is crucial for obtaining the necessary licensing to operate legally in Texas.
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When filling out the Texas Vtdlr Sls 017 form, it is important to follow specific guidelines to ensure accuracy and compliance. Here are six things to do and not do:
TEXAS DEPARTMENT OF LICENSING AND REGULATION
P. O. Box 12157 • Austin, Texas 78711 • (800) 803-9202 • Fax (512) 463-5984
E-mail: staff.leasing.services@license.state.tx.us 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
___________________________________________________________________________________________________________
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?
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? (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)
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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
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
__________________________________
_________________
_________
_____________________
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
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When applying for a staff leasing services license in Texas using the Texas VTDLR SLS 017 form, several additional documents may be required to ensure compliance with state regulations. Each of these documents serves a specific purpose in the application process, helping to verify the legitimacy and operational capacity of the business.
By ensuring that all these documents are accurately completed and submitted alongside the Texas VTDLR SLS 017 form, applicants can facilitate a smoother licensing process and demonstrate their commitment to compliance with state regulations.
Filling out the Texas VTDLR SLS 017 form can be straightforward, but many make common mistakes that can delay the application process. One frequent error is failing to provide the correct business name. The name on the application must match exactly with the name registered with the Texas Secretary of State. If there is a discrepancy, it can lead to rejection of the application. Always double-check that the business name is spelled correctly and is consistent throughout all documents.
Another common mistake involves the Federal ID Number (FEIN). Applicants sometimes leave this field blank or provide an incorrect number. This ID is crucial for identification purposes and must be accurate. Ensure that you have the correct FEIN before submitting the form. If you do not have one, apply for it through the IRS prior to filling out the form.
Many applicants overlook the requirement for an audited financial statement. The form specifies that all staff leasing services companies must submit this document to demonstrate positive working capital. Some people either forget to include it or submit an outdated statement. This can result in delays or denial of the application. It’s essential to gather this documentation ahead of time and ensure it meets the specified criteria.
Lastly, some individuals fail to sign and date the application. This may seem like a minor detail, but without a signature, the application is considered incomplete. Make sure to review the entire form before submission, ensuring all required fields are filled out, and don’t forget to sign and date where indicated. Taking these steps can help avoid unnecessary complications and ensure a smoother application process.
When it comes to the Texas VTDLR SLS 017 form, several misconceptions can lead to confusion. Understanding these can help streamline the application process for staff leasing services. Here are four common misconceptions:
This is not true. The SLS 017 form is applicable to all staff leasing companies, regardless of size. Even if a company has fewer than 50 employees, it must still complete and submit this form.
On the contrary, submitting an audited financial statement is a requirement. This document must demonstrate positive working capital, which is crucial for obtaining the license.
This is misleading. Only specific documents, such as a worker's compensation certificate of insurance, should be submitted. Other types of insurance documents are not required and should not be included.
In fact, applicants must provide documentation from the Texas Secretary of State that recognizes their business entity. This step is essential for a complete application.
Filling out the Texas VTDLR SLS 017 form can seem daunting, but understanding the key points can simplify the process. Here are some essential takeaways to keep in mind:
By keeping these points in mind, you can navigate the Texas VTDLR SLS 017 form more effectively. Good luck with your application!
Once you have gathered the necessary information, you can begin filling out the Texas Vtdlr Sls 017 form. Make sure to provide accurate details, as any mistakes may delay the processing of your application. After completing the form, you will need to gather required attachments and submit everything to the appropriate address.
After completing these steps, review the form and all attachments for accuracy. Then, submit everything to the address listed at the top of the form. Make sure to include the appropriate fees to avoid any delays in processing your application.