Purpose of form: This form serves the purpose of separating compensation experience between a predecessor and a successor.
Who can use this form: The business being transferred, must be a definitely identifiable
and segregable portion of the predecessor business per Section
204.084(c)(3). In order to meet "definitely identifiable and segregable" portion of
204.084, the employer must show, in their application, that the predecessor operated two or more
distinct operations or locations that are able to operate independently and separately from each
Requirements: This form must be used in conjunction with Form C-82 (Joint Application for Partial Transfer of Compensation Experience). Applications must be submitted no later than the first anniversary of the effective date of the acquisition.
If you have any questions or need assistance in completing the Form C-83, please contact our Experience Rating Unit of the Tax Department by phone at (512) 463-2887 or by e-mail at firstname.lastname@example.org.