Utah Employment Agency

Professional Employer Organization – Licensed Through An Assurance Organization Application

$2,050

• Business location of each Utah office
• An explanation and any documentation pertaining to any adverse regulatory action taken by any state or federal regulatory law enforcement or regulatory agency against the PEO, an owner, a director, an officer, or senior executive officer (if applicable)
• A copy of the certificate from the assurance organization certifying the qualifications of the professional employer
  organization
• A list of the Professional Employer Organization Utah clients

Professional Employer Organization – Not Licensed Through An Assurance Organization Application

$2,050

• Business location of each Utah office
• An explanation and any documentation pertaining to any adverse regulatory action taken by any state or federal regulatory law enforcement or regulatory agency against the PEO, an owner, a director, an officer, or senior executive officer (if applicable)
• A copy of the applicant’s articles of incorporation or other business organization documents
• A list by jurisdiction of each name under which the applicant has operated in the preceding five years, including alternate names, names of predecessors and, if known, successor business name
• A list of applicant’s Utah clients
• Documentation that demonstrates the PEO or collectively the professional employer organization group has at least $100,000 in working capital as determined by generally accepted accounting principles or a bond, an irrevocable letter of credit, or one or more credits or securities in an amount of at least $100,000
• A copy of the applicant’s most recent financial statement that:
  • is prepared on a GAAP basis;
  • is audited by an independent CPA;
  • complies with Section 31A-40-205; and
  • complies with Section 31A-40-305
• A statement of ownership that:
  • includes the name of a person that, individually or acting in concert with one or more persons, owns or controls, directly or indirectly, 10% or more equity interest in the PEO; and
  • includes a completed Biographical Affidavit for each named person
• A list of all individuals who serve as a director, president, chief executive officer, or senior executive officer of the PEO with a completed Biographical Affidavit, found on the Departments Web Site, for each individual on the list
• Documentation explaining how the applicant meets, or will meet, the workers’ compensation requirements of 31A-40-209
• Documentation explaining how the applicant meets, or will meet, the unemployment compensation insurance requirements of 31A-40-210
• Documentation on health benefit plans, if offered by the PEO

Professional Employer Organization – Not Licensed Through An Assurance Organization Application (Renewal)

$2,050

Annually by September 30.

• Business location of each Utah office
• An explanation and any documentation pertaining to any adverse regulatory action taken by any state or federal regulatory law enforcement or regulatory agency against the PEO, an owner, a director, an officer, or senior executive officer (if applicable)
• A copy of the applicant’s articles of incorporation or other business organization documents
• A list by jurisdiction of each name under which the applicant has operated in the preceding five years, including alternate names, names of predecessors and, if known, successor business name
• A list of applicant’s Utah clients
• Documentation that demonstrates the PEO or collectively the professional employer organization group has at least $100,000 in working capital as determined by generally accepted accounting principles or a bond, an irrevocable letter of credit, or one or more credits or securities in an amount of at least $100,000
• A copy of the applicant’s most recent financial statement that:
  • is prepared on a GAAP basis;
  • is audited by an independent CPA;
  • complies with Section 31A-40-205; and
  • complies with Section 31A-40-305
• A statement of ownership that:
  • includes the name of a person that, individually or acting in concert with one or more persons, owns or controls, directly or indirectly, 10% or more equity interest in the PEO; and
  • includes a completed Biographical Affidavit for each named person
• A list of all individuals who serve as a director, president, chief executive officer, or senior executive officer of the PEO with a completed Biographical Affidavit, found on the Departments Web Site, for each individual on the list (If there have been no changes since previous application was filed, mark “No Change”)
• Documentation explaining how the applicant meets, or will meet, the workers’ compensation requirements of 31A-40-209
• Documentation explaining how the applicant meets, or will meet, the unemployment compensation insurance requirements of 31A-40-210
• Documentation on health benefit plans, if offered by the PEO