Form Ui-5 - Montana Employer'S Unemployment Insurance (Ui) Quarterly Wage Report printable pdf download

Form Ui-5 - Montana Employer'S Unemployment Insurance (Ui) Quarterly Wage Report

Montana Employer’s Unemployment Insurance (UI)

Quarter End

Due Date

Quarterly Wage Report – Form UI-5

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

(Each Employee)

$30,500.00

A report must be filed even if no wages are paid. Instructions for completing this form

are online at

or call 406-444-3834. File online

UIeServices.mt.gov

. If paying by check, please use attached voucher.

Step 1.

No Wages paid for the quarter covering this report

Check

Sold Business – Name, address and phone number of new owner:

applicable boxes

Ceased Employing – Last payroll date ______/_____/_____

and provide

Change in Name, Address, Phone Number or Identification Number (list corrections here): ______________________

information

Amended Report

requested:

Step 2. Unemployment Insurance Employee Wage Listing

Check here if wage listing is attached.

Employee’s Social Security

Name of Employee

Total Wages

Excess Wages

Number

Paid this Quarter

This Quarter

Last Name

First Name

Totals

Step 4. Number of

State Unemployment

Step 3. Calculate Tax

Insurance Tax

UI Employees



1. Total wages paid this quarter

Number of covered



2. UI excess wages (Except Governmental and Reimbursable Accts.)

workers who worked



during, or received pay for,

3. UI taxable wages (line 1 minus line 2)

the payroll period that

4. UI total tax rate

includes the 12

day of

5. Total tax (multiply line 3 times line 4)

the month:

6. Credits (overpayment from prior quarters)

month ____________

7. Adjustments to prior quarters (attach explanation)

month ____________

8. Balance due (line 5 – line 6 +/- line 7 -- see instructions)

9. If filing late, add penalty ($25) and interest (line 8 x 1.5% x month(s) past due)

month _____________



10. Payment enclosed (line 8 +9)

Make Check Payable to Unemployment Insurance Division

Step 5. Signature.

Sign and make a copy of this form for your records. Mail your report, additional wage listings and payment by the due date

above, even if no wages are paid or tax is due. Questions? Call (406) 444-3834.

Mail to:

I certify the information on this report is true and correct.

Date:

Unemployment Insurance

Contributions Bureau

Authorized Signature

Telephone Number

Name of Contact Person

Telephone No

PO Box 6339

Helena MT 59604-6339

Mail this form with your check to the Unemployment Insurance Contributions Bureau

UI-5 Revised 2/16

Form Ui-5 - Montana Employer'S Unemployment Insurance (Ui) Quarterly Wage Report

Related Articles

Related forms

Related Categories