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- Click ‘Get Form’ to open the MODES-4282 document in the editor.
- Begin by entering the Lessor Employing Unit Name and Contact Person details in the designated fields. Ensure accuracy for effective communication.
- Fill in the Lessor Employing Unit Account Number and Telephone Number. This information is crucial for identification and follow-up.
- Indicate whether you financially guarantee payment by selecting 'Yes' or 'No'.
- Complete the Quarterly Client List section by providing each client’s Federal ID Number, Legal Name, Mailing Address, Nature of Business, and Physical Worksite Address.
- For each client listed, specify Agreement Dates (Effective and Ceased) and confirm if they are still in business by selecting 'Yes' or 'No'.
- If necessary, attach additional pages for more clients or details as required.
- Once completed, save your document and follow submission instructions to fax or mail it to the Liability Unit.
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