Form Ui-5e - Montana Employer'S Unemployment Insurance (Ui) Quarterly Payment Transmittal

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Montana Employer’s Unemployment Insurance (UI)
Quarter End
Due Date
Quarterly Payment Transmittal – UI-5E
Employer Identification Numbers
UI Account Number
Federal Id (FEIN)
UI Contribution Rate
%
UI Administrative Fund Tax Rate
%
UI Total Tax Rate
%
UI Annual Taxable Wage Base
$ 27,900.00
(Each Employee)
A quarterly report must be filed even if no wages are paid. If you paid no wages, check
the box below and write “None” on the “payment enclosed” line. (Do not return this
form if you filed a “none” report via the Internet filing method.) To pay on-line, go to
wow.mt.gov
to register for Warp on the Web, our on-line filing and payment service.
Check here if no wages were paid for the quarter covered by this report.
Credit (UI overpayments from prior quarters)
$
Step 1:
Payment Information
Amount of Payment Enclosed (Tax Due minus any Credit): $
Do Not Return this form if
payment was made
Make Check Payable to Unemployment Insurance Division
electronically by ACH debit.
I no longer wish to receive the UI-5E Payment Transmittal Form in the mail
Diskette
Step 2.
Reporting Method:
FTP via Secure File Transfer
Check the method used to
file your UI quarterly wage
CD
report (check only one box).
Internet (WOW)
Ceased Employing – Last payroll date ______/_____/_____
Step 3.
S
Changes/
Sold Business – Name, address and phone number of new owner:
T
Corrections
A
Note changes by
Change in Name, Address, Phone Number or Identification Number (list corrections below):
P
checking the applicable
L
box(es) and providing
E
information requested:
C
H
Step 4. Signature.
E
I certify the information on this report
Date:
Sign and make a copy of
C
is true and correct.
this form for your records.
K
Questions?
Authorized Signature
Title
Name/Title of Contact Person
Call (406) 444-3834.
H
E
Mail to:
R
Telephone Number
Telephone No
Unemployment Insurance
E
Contributions Bureau
PO Box 6339
Helena MT 59604-6339

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