Oklahoma Employment Security Commission
Application for Oklahoma UI Tax Account Number OES-001(9/23)
1. Business or Trade name Telephone No. 2. Federal Identification
EMHS OPUS INC (432) 606-1698 27-5318674
3. Business mailing address (no. & St.) (City or Town) (State) (Zip)
1027 RUMSEY AVE ERIE PA 16511
4. Type of Organization: Tribal Rated Sole Proprietor Partnership ■ Corporation LLC Ltd Partnership
Tribal Reim Non-Profit Rated Non-Profit Reim Gov 1% Gov Reim Other (Specify)
5. Owners/Partners/Corp Officers/Members Title Residence Address Telephone Stock Ownership%
Name- Kirk Suttles Owner 308 Elwood Dr Edmond OK 73013 100
SSN#-
Name-
SSN#-
Name-
SSN#-
6. If a Corporation, or LLC Enter Full Name State of Incorporation Date of filing
EMHS OPUS INC or Filing OK
7. If an LLC how have you chosen to be taxed for federal tax purposes? 8. Email Address:
Sole Proprietor Partnership Corporation
9. Is your Business a nonprofit organization? Yes No Do you have a 501(c)(3) exemption? Attach Copy. Yes No
10. Date entered business in Oklahoma: 11. NAICS Code 12. Date of first payroll in Oklahoma:
03/04/23 03/12/23 03/28/23
13. Describe the exact nature of your business or employment activity and list the principal products
manufactured or traded in Oklahoma: Educational Services
14. Did you acquire an established business in Oklahoma? Yes No ■
If Yes, did you acquire substantially all of the Oklahoma trade, organization, employees, business or assets? Yes No
See O.S. 40 3-111 and 3-111.1 Date of acquisition:_____________________________
Name, Address and Oklahoma account number of former owner.
15. Are you liable under the Federal Unemployment Tax Act? Yes No ■ If Yes, enter year liable:
16. If you have previously filed reports to the Oklahoma Employment Security Commission list name and account number:
NO
17. List addresses of all locations in Oklahoma: (1) 1000 E 15th St Edmond OK 73013
(2) (3)
18. Enter gross Oklahoma payroll for the current and two prior calendar years:
1st Qtr. 2nd Qtr. 4th Qtr.
*Required Calendar Year 3rd Qtr.
2023 $ 11074.00 $ 16507.00 $ 16507.00 $ 16507.00
2024 $ 16592.00 $ 11074.00 $ 11074.00 $
$ $ $ $
19. Enter by week the number of workers you employed in Oklahoma during the same period.
1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th
2023 wk.
Yr___ wk. wk. wk. wk. 2024 wk.
Yr___ wk. wk. wk. wk. Yr___ wk. wk. wk. wk. wk.
Jan. Jan. 3 3 3 3 3 Jan.
Feb. Feb. 3 3 3 3 3 Feb.
Mar. 3 3 3 Mar. 3 3 3 3 3 Mar.
Apr. 3 3 3 3 3 Apr. 3 3 3 3 3 Apr.
May 3 3 3 3 3 May 3 3 3 3 3 May
Jun. 3 3 3 3 3 Jun. 3 3 3 3 Jun.
Jul. 3 3 3 3 3 Jul. 3 3 3 3 3 Jul.
Aug. 3 3 3 3 3 Aug. 3 3 3 3 3 Aug.
Sep. 3 3 3 3 3 Sep. 3 3 3 3 3 Sep.
Oct. 3 3 3 3 3 Oct. 3 3 3 3 3 Oct.
Nov. 3 3 3 3 3 Nov. 3 3 3 3 3 Nov.
Dec. 3 3 3 3 3 Dec. Dec.
Note: Must be signed by owner, all partners, corporate officers or authorized official.
OWNER 12/16/24
20. Signed:_____________________________________ Title __________________________________Date_____________________
For Commission use only Control No.
State No FEIN
L-Date E-Date S-Date R-Date
L-Code Pred No
Auxiliary Aids and Services are available upon request to individuals with disabilities
Instructions for preparation of form OES-1, Application for Oklahoma UI Tax Account Number
1. Enter the name by which the business is known. Examples: “A & B Hardware”, Whiteway Theater, McDonalds, O’Reilly’s,
Starbucks, etc. List your business telephone number.
2. Enter Your Federal Identification Account Number.
3. Enter address to which forms for reports, notices and correspondence should be mailed by Commission.
4. Enter a check mark after the word that properly describes type of ownership of your business.
5. Enter full name, residence address, telephone number and Social Security Number of all owners,
partners, corporate officers or members. Attach additional sheet if sufficient space is not provided.
All corporate officers, including officers of Sub-Chapter S corporations, are considered employees for
unemployment tax reports.
6. Enter full corporate name (as it appears on your corporate seal), date of incorporation or filing and State
which incorporated.
7. When you reported to the U.S. Internal Revenue Service that you were chartering a limited liability
company, you were required to “check the box” on IRS Form 8832 to inform them how you wanted to be taxed.
Your answer here should be the same as you selected for federal tax purposes.
8. Enter the email address you want contacted for your business.
9. If your answer is “Yes”, please attach a copy of your letter of exemption from the Internal Revenue Service.
10. Date your firm entered business in Oklahoma.
11. North American Industry Classification code.
12. Enter the date first payroll was issued for services performed in Oklahoma.
13. State what kind of business you operate in Oklahoma and the principal product manufactured or traded.
14. If your answer was “Yes”, please enter name and address of former owner and date acquired.
15. If “Yes”, enter the year you first became liable.
16. Self explanatory.
17. List addresses of all locations in Oklahoma where services are performed. If the physical location of your business is out of state, you
must still list the Oklahoma address where services are performed even if they are performed by home-based employees. Attach additional
sheet if necessary.
18. Enter gross payroll of your business by quarter for the current year and the preceding two (2) calendar
years (Oklahoma payroll only).
19. Enter by week the number of workers to whom you furnished employment in Oklahoma. Include both
full-time and part-time employees. Indicate current calendar year employment followed by employment
in preceding calendar years. A week is seven (7) consecutive calendar days beginning at 12:01 A.M.
Sunday and ending at 12:00 midnight on the next succeeding Saturday.
20. Must be signed by owner, partner, corporate officer or authorized official.
Mail completed and signed form to: Oklahoma Employment Security Commission
PO Box 52003
Oklahoma City OK 73152-2003
(405)552-6799 (5)
employerunitfax@oesc.ok.gov
