Part #4 - Payment of contributions or payments in lieu of contributions to the Nevada
Employment Security Department as required by Chapter 612 of the Nevada Revised Statutes.
Include Nevada Employment Security Dept (DETR) Notice of Contribution or Wage
Report for each client listed in Section C of the application. (Confirmation from
DETR showing that an account number has been assigned may be submitted for new
companies.) The forms should be in the same order as the list of clients.
Part #5 – Financial Statement and Proof of Working Capital
NRS 616B.679(1)(h)
1.
(h) A financial statement of the applicant setting forth the financial condition of the Professional
Employer Organization. Except as otherwise provided in NRS 616B.679 subsection 5, the financial
statement must include, without limitation:
(1)
For an application for issuance of a certificate of registration, the most
recent audited financial statement that includes the applicant, which must have been
completed not more than 13 months before the date of application; or
(2)
For an application for renewal of a certificate of registration, an audited
financial statement that includes the applicant and which must have been completed
not more than 180 days after the end of the applicant’s fiscal year.
NRS 616B.679 subsection 5 and 6
5.
A financial statement submitted with an application pursuant to this section must be prepared in
accordance with generally accepted accounting principles, must be audited by an independent
certified public accountant licensed to practice in the jurisdiction in which the accountant is located
and must be without qualification as to the status of the Professional Employer Organization as a
going concern. Except as otherwise provided in subsection 6, a Professional Employer Organization
that has not had sufficient operating history to have an audited financial statement based upon at
least 12 months of operating history must present financial statements reviewed by a certified
public accountant covering its entire operating history. The financial statements must be prepared
not more than 13 months before the submission of an application and must:
(a)
Demonstrate, in the statement, positive working capital, as defined by generally accepted
accounting principles, for the period covered by the financial statements; or
(b)
Be accompanied by a bond, irrevocable letter of credit or securities with a minimum market
value equaling the maximum deficiency in working capital for the period covered by the financial
statements plus $100,000. The bond, irrevocable letter of credit or securities must be held by a
depository institution designated by the to secure payment by the applicant of all taxes, wages,
benefits or other entitlements payable by the applicant.
6.
An applicant required to submit a financial statement pursuant to this section may submit a
consolidated or combined audited financial statement that includes, but is not exclusive to, the
applicant.
Please mark the appropriate box for items included:
Audited Financial Statement Bond
Irrevocable Letter of Credit Securities
Include a copy of the appropriate page that demonstrates working capital in the
application.