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Content Overview

The Texas Vtdlr Sls 017 form is a crucial document for businesses seeking to obtain a limited license for staff leasing services in Texas. This form requires detailed information about the business, including its name, federal ID number, and ownership structure. Applicants must provide both physical and mailing addresses, along with contact details for a designated representative. Importantly, the form includes questions that determine the company's operations in Texas, such as the number of employees assigned and whether the business maintains an office in the state. Additionally, applicants must submit an audited financial statement to demonstrate positive working capital, which is a key requirement for licensure. This statement must be prepared by an independent certified public accountant and meet specific financial thresholds based on the number of employees. The form also requests information about insurance coverage, including worker’s compensation, and requires the submission of various attachments, such as a certificate of insurance and documents from the Texas Secretary of State. Completing the Texas Vtdlr Sls 017 form accurately is essential for compliance and to ensure a smooth application process.

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3. Please indicate the type of ownership for this company:
Corporate Partnership Individual Limited Liability Company
FEE RECEIPT NUMBER
PMT.
AMOUNT
MONEY
TYPE
$900
DO NOT WRITE IN THE FEE AREA IMMEDIATELY ABOVE
1. Name of Business to be Licensed :_________________________________________________________
DBA (if applicable):_______________________________________________________________________
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.
6. Business Phone:__________________________________ 7. Business Fax:________________________
TDLR Form SLS 017 (12/2011) Page 1 of 3
4. Business Physical Address:________________________________________________________________
NUMBER AND STREET
__________________________________________________________________________________________________________
CITY STATE ZIP
9. Contact person: _________________________________________________ Title:______________________
10. Contact e-mail:______________________________ 11. Contact phone:_____________________________
YOU MUST COMPLETE ALL OF THE INFORMATION REQUESTED ON THIS FORM AND ALL OF THE REQUIRED
ATTACHMENTS. PLEASE CONTINUE TO PAGE 2.
5. Business Mailing Address: ________________________________________________________________
NUMBER AND STREET OR PO BOX
___________________________________________________________________________________________________________
CITY STATE ZIP
2. Federal ID Number (FEIN):__________________________________________________________________
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.
Staff Leasing Services Application: New Limited License
Company Information
Contact Information
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
PLEASE CONTINUE TO PAGE 3. Page 2 of 3
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 Signature Date
__________________________________________________________________________________________________________
Authorized Representative’s Printed Name Date
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
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. F
or 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.
NAME OF INSURER TYPE OF COVERAGE EFF. DATE EXP. DATE POLICY NUMBER
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
__________________________________ _________________ _________ _________ _____________________
Page 3 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
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

Form Specifications

Fact Name Details
Governing Law The Texas Staff Leasing Services Act, Title 2, Labor Code, Subtitle E governs the use of this form.
Purpose This form is used to apply for a new limited license for staff leasing services in Texas.
Application Fee A fee of $900 is required to process the application.
Business Information Applicants must provide the business name, DBA (if applicable), and Federal ID Number.
Ownership Types The form allows for various ownership types, including corporate, partnership, individual, and limited liability company.
Employee Count Questions regarding the number of employees assigned in Texas must be answered, including whether the company has fewer than 50 employees.
Working Capital Requirements Applicants must submit an audited financial statement demonstrating positive working capital, which varies based on employee count.
Insurance Requirements Companies must provide a certificate of insurance for worker's compensation if applicable, along with other insurance information.
Controlling Persons A Controlling Person Personal Information Form must be submitted for each controlling person of the company.
Signature Requirement The application must be signed by an authorized representative, certifying that all information is true and correct.

Texas Vtdlr Sls 017: Usage Guidelines

Completing the Texas VTDLR SLS 017 form is a crucial step for businesses seeking a staff leasing services license. The information you provide will assist in the processing of your application. Ensure that all required sections are filled out accurately and that you attach any necessary documents as specified in the form.

  1. Business Information: Write the name of your business in the designated space. If applicable, include the "Doing Business As" (DBA) name.
  2. Enter your Federal ID Number (FEIN) in the next field.
  3. Select the type of ownership for your company by marking the appropriate box: Corporate, Partnership, Individual, or Limited Liability Company.
  4. Provide your business's physical address, including the street number, city, state, and ZIP code.
  5. Fill in the mailing address, which can be a street address or a P.O. Box, along with the city, state, and ZIP code.
  6. Input your business phone number and fax number.
  7. Answer the following questions: Indicate "Yes" or "No" for each question regarding employee count, client assignments, solicitation, office maintenance, and licensing in other states. Fill in the number of employees assigned in Texas and the state where your company is domiciled.
  8. Contact Information: Provide the name, title, email, and phone number of the contact person for your application.
  9. Attach a copy of the document from the Texas Secretary of State that recognizes your business entity. Ensure it matches the business name on the application.
  10. Working Capital Requirements: Include your most recent audited financial statement that demonstrates positive working capital. Make sure it meets the specified amounts based on your employee count.
  11. Submit a Controlling Person Personal Information Form for each controlling person in your company, as well as a Controlling Corporation Information Form if applicable.
  12. Attach a Worker’s Compensation Certificate of Insurance if you offer this insurance to employees in Texas.
  13. Complete the Insurance Information Form for any other types of insurance offered to employees assigned in Texas, if applicable.
  14. Provide information for your designated agent for service in Texas, including their name, phone number, and address.
  15. Sign and date the application, certifying that all information is accurate and that you will notify the department of any changes within 45 days.

After completing the form, ensure all attachments are included. Submit the application along with the appropriate fees to the address provided at the top of the first page. For further assistance or additional forms, visit the Texas Department of Licensing and Regulation website.

Your Questions, Answered

What is the Texas VTDLR SLS 017 form used for?

The Texas VTDLR SLS 017 form is an application for a new limited license for staff leasing services companies operating in Texas. This form is essential for businesses that wish to legally assign employees to client companies within the state. By completing this form, a company provides necessary information about its operations, ownership structure, and financial standing, ensuring compliance with state regulations. The form also requires documentation to demonstrate that the business meets specific working capital requirements, which are crucial for maintaining a license.

What information is required to complete the Texas VTDLR SLS 017 form?

To successfully complete the Texas VTDLR SLS 017 form, a business must provide several key pieces of information. This includes the name of the business, its Federal ID Number, and the type of ownership (such as corporate or partnership). Additionally, the form requires both physical and mailing addresses, along with contact details for a designated representative. Applicants must also answer questions regarding the number of employees assigned in Texas, the business's operational status in the state, and whether the company is licensed in its home state. Furthermore, an audited financial statement demonstrating positive working capital must be submitted, along with any required insurance certificates.

What are the working capital requirements for staff leasing services companies?

According to Texas regulations, staff leasing services companies must demonstrate positive working capital, which is calculated as current assets minus current liabilities. The specific amount required varies based on the number of employees assigned in Texas. For companies with fewer than 250 employees, the requirement is $50,000. If a company employs between 250 and 750 employees, the requirement increases to $75,000. For those with more than 750 employees, a minimum of $100,000 is necessary. It's important to note that surety bonds or letters of credit cannot be used alone to satisfy these requirements; an audited financial statement is mandatory.

How do I submit the Texas VTDLR SLS 017 form?

The completed Texas VTDLR SLS 017 form, along with all required attachments and the appropriate fees, must be submitted to the Texas Department of Licensing and Regulation. The mailing address is provided at the top of the form. It is crucial to ensure that all sections of the form are filled out completely and accurately, as any omissions may delay the application process. For additional forms and further information, the department’s website serves as a valuable resource.

What happens if I do not notify the Texas Department of Licensing and Regulation about changes to my application?

Failure to notify the Texas Department of Licensing and Regulation about any changes in the information provided on the Texas VTDLR SLS 017 form can lead to serious consequences. Licensure may be subject to revocation if the department is not informed, in writing, of any changes within 45 days. This includes changes in ownership, operational status, or any other significant alterations to the business. Therefore, maintaining open communication with the department is essential to ensure compliance and avoid potential penalties.

Common mistakes

  1. Incomplete Information: One of the most common mistakes is failing to fill out all required fields. Each section of the Texas Vtdlr Sls 017 form must be completed. Omitting details such as the business name, federal ID number, or contact information can lead to delays or outright rejection of the application.

  2. Incorrect Business Name: It is crucial that the business name on the application matches exactly with the name recognized by the Texas Secretary of State. Any discrepancies can cause confusion and may result in the application being denied. Double-checking the spelling and format can save time and frustration.

  3. Missing Attachments: The form requires several attachments, including an audited financial statement and documents from the Texas Secretary of State. Forgetting to include these documents can lead to significant delays. It is advisable to create a checklist of required attachments before submission.

  4. Failure to Certify Information: The authorized representative must sign and date the application to certify that all information is true and correct. Neglecting to do this can invalidate the application. It is important to ensure that the signature is present before sending in the form.

Documents used along the form

The Texas VTDLR SLS 017 form is an important document for businesses seeking a staff leasing services license. To complete the application process, several other forms and documents may be required. Below is a list of commonly used documents that accompany the SLS 017 form.

  • Texas Secretary of State Document: This document verifies the business entity's existence and must match the business name on the application. It can be a Certificate of Authority or Certificate of Incorporation.
  • Audited Financial Statement: This statement demonstrates the company’s positive working capital. It must be prepared by an independent certified public accountant and show current assets minus current liabilities.
  • Controlling Person Personal Information Form: This form provides personal information about individuals who have significant control over the company. Each controlling person must submit a separate form.
  • Controlling Corporation Information Form: If applicable, this form details information about any controlling corporations associated with the business. It helps establish the corporate structure.
  • Worker’s Compensation Certificate of Insurance: If the business offers worker’s compensation insurance, a certificate from an authorized insurer must be included. This protects employees assigned in Texas.
  • Insurance Information Form: This form lists all types of insurance coverage offered to employees. It is necessary to provide details about any insurance besides worker’s compensation.
  • Designated Agent for Service Information: This document provides contact information for the agent designated to receive legal documents on behalf of the business in Texas.
  • Authorized Signature: This section requires the signature of an authorized representative, certifying that all information provided is accurate and complete.

Gathering these documents ensures a smoother application process for the Texas staff leasing services license. Proper preparation can help avoid delays and complications in obtaining the necessary approvals.

Similar forms

The Texas VTDLR SLS 017 form is used for applying for a staff leasing services license. It has similarities with several other documents that serve different licensing and regulatory purposes. Here are five documents that share similarities with the SLS 017 form:

  • Texas Secretary of State Certificate of Authority: This document shows that a business entity is authorized to operate in Texas. Like the SLS 017, it requires specific business information and must be issued in the exact name of the applicant.
  • Business License Application: Similar to the SLS 017, a business license application collects information about the business, its ownership structure, and contact details. Both documents ensure compliance with state regulations before a business can operate.
  • Employer Identification Number (EIN) Application: Both the EIN application and the SLS 017 require a Federal ID number. This number is essential for tax purposes and is a key identifier for businesses operating in the U.S.
  • Financial Statement Submission: Just as the SLS 017 requires an audited financial statement to demonstrate positive working capital, other regulatory forms often require financial disclosures to ensure the business's financial stability.
  • Insurance Information Form: The SLS 017 includes an insurance information section. Similarly, other forms often require proof of insurance coverage to protect employees and clients, ensuring compliance with state laws.

Dos and Don'ts

When filling out the Texas VTDLR SLS 017 form, it's important to follow certain guidelines to ensure your application is processed smoothly. Here are four things you should and shouldn't do:

  • Do complete all sections of the form accurately. Ensure that every required field is filled out to avoid delays.
  • Do attach all necessary documents, such as your audited financial statement and any certificates of insurance, as specified in the instructions.
  • Don't leave any questions unanswered. If a question does not apply to your business, indicate that clearly instead of skipping it.
  • Don't forget to sign and date the application. An unsigned form may be returned, causing unnecessary delays in processing.

Misconceptions

  • Misconception 1: The SLS 017 form is only for large companies.
  • This form is designed for businesses of all sizes. Whether you have a handful of employees or a larger workforce, if you are involved in staff leasing services in Texas, this form is relevant to you.

  • Misconception 2: I don’t need to submit financial statements if I have fewer than 50 employees.
  • Even small companies must provide an audited financial statement to demonstrate positive working capital, regardless of employee count. This requirement ensures that all businesses meet certain financial standards.

  • Misconception 3: The form can be submitted without all required attachments.
  • It is crucial to include all necessary documents when submitting the SLS 017 form. Incomplete applications may lead to delays or denials, so double-check your submission.

  • Misconception 4: I can use a surety bond as proof of working capital.
  • This is incorrect. The Texas Department of Licensing and Regulation no longer accepts surety bonds alone as proof. An audited financial statement is mandatory for all applicants.

  • Misconception 5: The form is only for new businesses.
  • The SLS 017 form is applicable for both new and renewing businesses. If your company is already licensed but needs to renew, you still need to complete this form.

  • Misconception 6: I can submit the form electronically.
  • Currently, the SLS 017 form must be submitted in hard copy. Ensure you send it to the correct address listed on the form to avoid any issues.

  • Misconception 7: I can skip the section on controlling persons.
  • All applicants must provide information about controlling persons. This is a key part of the application process and helps the state verify the integrity of the business owners.

  • Misconception 8: I don’t need to inform the TDLR about changes after submitting the form.
  • It is essential to notify the Texas Department of Licensing and Regulation of any changes within 45 days. Failing to do so can result in license revocation.

Key takeaways

When filling out and using the Texas VTDLR SLS 017 form, consider the following key points:

  • Complete all sections: Ensure every field on the form is filled out accurately to avoid delays in processing.
  • Provide accurate business information: Include the exact business name, DBA, and federal ID number to match official records.
  • Ownership type: Clearly indicate the type of ownership, whether it's corporate, partnership, individual, or LLC.
  • Attach required documents: Include a copy of the Texas Secretary of State document and an audited financial statement.
  • Understand working capital requirements: Know the minimum positive working capital needed based on employee count.
  • Insurance documentation: Submit a worker’s compensation certificate if applicable, along with the Insurance Information Form.
  • Designated agent: Provide complete contact information for your designated agent for service in Texas.
  • Sign and date: Ensure the authorized representative signs and dates the application to validate the submission.