Form Uia 1027 - Business Transferor'S Notice To Transferre Of Unemployment Tax Liability And Rate Page 2
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2UIA 1027
Rev. 05-16
Page 2
Calendar Year
Calendar Year
Calendar Year
Calendar Year
Calendar Year
20__
20__
20__
20__
20__
d. Unemployment Tax Rates
%
%
%
%
%
Non Reporting Penalty
%
%
%
%
%
Obligation Assessment
%
%
%
%
%
Solvency Rate
%
%
%
%
%
TOTAL
%
%
%
%
%
(e) the Actual Reserve as of the most recent past June 30
:_____________________
th
(f) the Required Reserve as of the most recent past June 30
:___________________
th
(g) the Total Payroll for the 12 months ending the most recent past June 30
:____________________
th
CERTIFICATION: I certify that the information contained on this form is accurate and complete to the best of my knowledge and
belief. I understand that criminal and civil penalties may apply for failure to provide accurate information on this form.
The person signing this form below is the:
Business Transferor
Transferor’s Real Estate Broker
Agent of Transferor
Attorney for Transferor
Name of Business: _____________________________________________ UI Employer Account No.:_____________________
Signature: ____________________________________ Date: ____________________ Telephone: _________________________
Typed or Printed Name of Signer: __________________________________________________________
Title of Signer: ________________________________________
NOTE TO TRANSFEREE: The information on this form may be up to 90 days old. Inquire from the Transferor as to updated information.
CERTIFICATION OF RECEIPT OF INFORMATION BY PROSPECTIVE TRANSFEREE
Name: _______________________________________________
Date: __________________________
Signature: ____________________________________________
Telephone: ______________________
UNEMPLOYMENT TAX RATE
A tax rate is composed of the Chargeable Benefits Component (CBC), the Account Building Component (ABC), and the
Nonchargeable Benefits (NBC). All rates are figured using the following calculations as provided by Section 19(a)(1) of the MES Act.
Chargeable Benefits Component (CBC):
Account Building Component (ABC):
60 months of benefit charges = CBC
(Required Reserve minus Actual Reserve) X 0.50 = ABC
60 months of taxable payroll
12 months of total payroll
The result is rounded up to the next higher 0.1%
The result is rounded up to the next higher 0.1%
The maximum value for the CBC is 6.3%
The maximum value for the ABC is 3.0%
Nonchargeable Benefits Component (NBC):
If there were Benefit Charges in any of the 5 years shown in question 5b of this form, the NBC is 1.0%. If the CBC was equal to
0.1%, the NBC is 0.5%. If there were no Benefit Charges for those 5 years, the NBC is 0.1%. If there were no Benefit Charges for
more than 5 years, the NBC may be as low as 0.06%. See Section 19(5) of the MES Act.
Obligation Assessment (OA):
Section 26a of the MES Act granted the State of Michigan the authority to issue bonds to reduce or eliminate Federal debt incurred
by the Unemployment Insurance Trust Fund. On December 29, 2011, the State of Michigan through the Michigan Finance Authority,
issued $3,320,951,556.55 in bonds and retired the debt and accrued interest. The Obligation Assessment (OA) represents the amount
required by law to repay the bonds. The OA is levied against all contributing employers and is part of the annual tax rate; however,
the OA is not credited to the employer’s experience account. The OA is added to the Total Tax Rate. See Fact Sheet #146 for further
information. For tax rate year 2011 only there was no OA in effect, but there was a solvency rate for employers with a negative
reserve balance. (If applicable, see Form UIA 1771 for the year 2011 to determine if , those rates apply to your account.)
Non-Reporting Penalty:
If any or all quarterly tax reports required for the computation of a tax rate are missing, a non-reporting penalty of 3% is added to the
Total Tax Rate in accordance with section 18(2) of the MES Act.
Total Tax Rate: The total rate is calculated by adding the three tax components (CBC + ABC + NBC) plus the OA, and non-reporting
penalty, (add your 2011 solvency rate) if applicable.
FOR ASSISTANCE IN COMPLETING THIS FORM, CONTACT THE OFFICE OF EMPLOYER OMBUDSMAN AT 1-855-484-2636
TTY CUSTOMERS CALL 1-866-366-0004
THIS FORM MUST BE PROVIDED TO PROSPECTIVE PURCHASERS.
TED is an equal opportunity employer/program.
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