Form For Unemployment Insurance Method Of Payment Election

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State of Montana
Agency Use Only
UNEMPLOYMENT INSURANCE
Department of Labor and Industry
Unemployment Insurance Division
UI Account No.
METHOD OF PAYMENT
Contributions Bureau
ELECTION
PO Box 6339
Helena, MT 59604-6339
This form is used for governmental or tribal entities or a non-profit organization
qualifying under Section 3306 (c) (8) of the Federal Unemployment Tax Act.
Business or Trade Name
Phone
Mailing Address
City
State
Zip Code
EXPLANATION:
Montana Unemployment Insurance Law requires coverage of non-profit organizations. In
establishing coverage for these organizations, the Department allows the organization to elect
one of the following methods of payment:
(1)
EXPERIENCE RATING METHOD – Contributions are paid quarterly based on taxable
wages and contribution rate assigned to the employer.
(2)
REIMBURSABLE METHOD* - The employer is required to reimburse the Unemployment
Insurance Trust Fund for benefit payments made to a former employee drawing
Unemployment Insurance benefits. Notification of benefit charges is sent monthly,
and payment of charges is due quarterly.
*IF THE REIMBURSABLE METHOD IS SELECTED, YOU MUST ATTACH A COPY OF YOUR
LETTER FROM THE INTERNAL REVENUE SERVICE WHICH EXEMPTS YOU UNDER SECTION
501 (C) (3) OF THE INTERNAL REVENUE CODE.
INSTRUCTIONS:
You must select one of the methods explained above. The method you select must be retained for the
current and following calendar year. After two years, to change the method of payment, a written
request must be filed with the Department by December 1 prior to the beginning of the taxable year for
which the change is to take place
(1)
In the boxes below, please indicate the method you elect.
(2)
Sign and return this form to:
UNEMPLOYMENT INSURANCE DIVISION
PO BOX 6339
HELENA, MT 59604-6339
Our organization selects the following method of payment for Unemployment Insurance:
EXPERIENCE RATING
REIMBURSABLE
Signature (must be officer of Corporation)
Phone Number
Title
Date
Election of Method of Payment 10/07
Telephone (406) 444-3834 Fax (406) 444-0629
Internet Address

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