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Get MT UI-5 2012

Montana Employer s Unemployment Insurance UI Quarterly Wage Report Form UI-5 Quarter End Due Date 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 A report must be filed even if no wages are paid. Instructions for completing this form are online at http //uid.dli. mt. gov/tax/uitaxforms. asp or call 406-444-3834. File online at UIeServices. mt. gov* If paying by check please use attached voucher. No Wages paid for the quarter covering this report Step 1. 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 Federal ID list corrections information Amended Report requested Step 2. Unemployment Insurance Employee Wage Listing Employee s Social Security Number Last Name Check here if wage listing is attached* Name of Employee First Name Total Wages Paid this Quarter Excess Wages This Quarter State Unemployment Insurance Tax Step 4. Number of UI Employees Totals Step 3. Calculate Tax 1. Total wages paid this quarter 2. UI excess wages Except Governmental and Reimbursable Accts. 3. UI taxable wages line 1 minus line 2 4. UI total tax rate 5. Total tax multiply line 3 times line 4 6. Credits overpayment from prior quarters 1st month 7. Adjustments to prior quarters attach explanation 2nd 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 10. Payment enclosed line 8 9 Number of covered workers who worked during or received pay for the payroll period th that includes the 12 day of the month Make Check Payable to Unemployment Insurance Division* Please use attached voucher. Step 5. Signature. Sign and make a copy of this form for your records. Mail your report additional wage listings and payment with voucher 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 Authorized Signature Title Telephone Number Name/Title of Contact Person Contributions Bureau PO Box 6339 Helena MT 59604-6339 Mail this form with your check and voucher to the Unemployment Insurance Contributions Bureau. mt. gov/tax/uitaxforms. asp or call 406-444-3834. File online at UIeServices. mt. gov* If paying by check please use attached voucher. No Wages paid for the quarter covering this report Step 1. 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 Federal ID list corrections information Amended Report requested Step 2. No Wages paid for the quarter covering this report Step 1. 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 Federal ID list corrections information Amended Report requested Step 2. Unemployment Insurance Employee Wage Listing Employee s Social Security Number Last Name Check here if wage listing is attached* Name of Employee First Name Total Wages Paid this Quarter Excess Wages This Quarter State Unemployment Insurance Tax Step 4. .

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