UI Forms

Unemployment Insurance

Employers

• LIR#27
  Application for Certificate of Compliance with Section 3-122-112, HAR (Use this form to request a tax clearance from the Department of Labor & Industrial Relations for Professional Service Awards)
• BB-1
  Basic Business Application (Use this form to register your business with the Unemployment Insurance Division when employment commences)
• *UC-B6
  Quarterly Wage, Contribution and Employment and Training Assessment Report
  (*Not available online - for assistance, please call 586-8915 or 586-8916)
• UC-25
  Notification of Changes (Use this form to notify the Unemployment Insurance Division of any changes to an employer's address or status of business)
• UC-336
  Election By Family Owned Corporation to be Excluded from coverage Under Section 383-7(20), HRS (Use this form to elect exclusion from unemployment insurance coverage of a family-owned corporation)
• UC-86
  Waiver of Employer's Experience Record (Use this form to request acquisition of the experience record of a predecessor employer)

UI Claimants

• UC-156
  Claimant's Election to Withhold Federal/State Income Tax  (Use this form to elect to have Federal and State taxes withheld.  Unemployment Insurance benefits, including Emergency Unemployment Compensation and Federal Additional Compensation are taxable income.  If you elect withholding, you are permitted only one change during your benefit year to stop withholding)
• UC-226
  Verification of Registration for Work  (You must register for work within 7 calendar days after the date you were advised to register by posting a resume online in HireNet.  You must take this form to WDD or a One-Stop office listed on the back to have Part A completed for verification of your registration for work and to have this form returned to your local unemployment office. If you will be referred to your next job by your union hiring hall, report to your union hall within 7 calendar days after filing your claim and have the union complete Part B of this form. Return the completed form to your unemployment office)
• UC-253
  Record of Contacts Made for Work
• UC-348
  Partial Unemployment Information (Information for claimants and employers on the definition, assessment and determination of partial unemployment. Also, includes the "Verification of Partial Unemployment Status" form for employers to compete and return to confirm their employee's partial unemployment status. This form is due within 5 working days from the date the application is filed.)
• Instructions for Partial and Part-Total Claimant's Filing Through the Web
   

   

  For Emergency Unemployment Compensation (EUC) information and forms, click here.