Division of Unemployment Insurance
Unemployment Insurance Employer Services
P.O. Box 8789, Denver, CO 80201-8789
303-318-9100 (Denver-metro area) or 1-800-480-8299 (outside Denver-metro area) | cdle.colorado.gov
UITR-13 (R 03/2023)
UNEMPLOYMENT INSURANCE PAYMENT ELECTION POLITICAL SUBDIVISION AND NONPROFIT EMPLOYERS
A political subdivision of the state of Colorado or a 501(c)(3) nonprofit employer may elect to make reimbursement payments in lieu of
premiums as provided in the Colorado Employment Security Act (CESA) 8-76-108 and 8-76-110(2). Nonprofit employers making this
election must submit a security amount that is determined in accordance with CESA 8-76-110(4) and the Regulations Concerning
Employment Security 8.1.
Legal Business Name
Unemployment Insurance Account Number
Trade or DBA Name (if applicable)
Mailing Address (include city, state, and zip code)
Telephone Number (Include area code)
501(c)(3) Nonprofit
A newly subject 501(c)(3) nonprofit employer may elect the reimbursement method of payment within 30 days of the date mailed on
Form UITL-3, Notice of Employer Liability and Unemployment Insurance Account Number . A subject 501(c)(3) nonprofit employer
may change its election for the following calendar year no later than December 1.
Choose one:
☐
Newly Subject Employer Election
The election will remain in force for not less than
the calendar year during which the organization was
determined to be subject.
☐
Subject Employer Election Change
This election will remain in force for not less than
two (2) calendar years beginning on January 1.
Choose one:
☐
Make quarterly premium payments.
A 501(c)(3) nonprofit electing this option is required to pay premiums on the total chargeable wages for each
employee on a quarterly basis.
☐
Make reimbursement payments in lieu of premiums.
A 501(c)(3) nonprofit electing this option is required to make payments to the Division in the full amount of all
regular benefits and one-half of the extended benefits paid that are attributable to service in the employ of the
501(c)(3) nonprofit. A security is required and the amount will be calculated by the Division.
Date Election Begins
Estimated Annual Gross Wages (newly subject employers only)
Political Subdivision of the State of Colorado (E.g., counties, municipalities, school and special districts)
A newly subject political subdivision may elect the reimbursement method of payment within 30 days of the date mailed on Form UITL-
3, Notice of Employer Liability and Unemployment Insurance Account Number. A subject political subdivision may change its election
no later than March 1 of the year for which the election is to be effective. The employer’s election may be changed on an annual basis.
Choose one:
☐
Make quarterly premium payments at the special group rate.
A political subdivision electing this option is required to pay premiums on the total subject wages for each
employee on a quarterly basis.
☐
Make reimbursement payments in lieu of premiums.
A political subdivision electing this option is required to make payments to the Division in the full amount of all
regular and extended benefits paid that are attributable to service in the employ of the political subdivision.
Date Election Begins
Signature
Title
Date
Department Use Only
Effective Date of Election Date of Approval
Approved By Title
NOPI INC
NOPI - Nonprofit Incubator
83 Morse Street