PART 5 - Benefit Reports Required by the Department

Unemployment Insurance Handbook for Employers (UCB-201-P)
Section 1 - Benefits

Employers are required to provide information to the department to determine the validity of Unemployment Insurance claims and to establish the correct amount of base period wages paid to the claimant.

Any person who knowingly makes a false statement or misrepresentation in connection with a required report may be subject to prosecution. (See Part 8 of this section.)

The three required benefit reports are:

1. Form UCB-16 Separation Notice
2. Form UCB-23 Wage Verification/Eligibility Report
3. Form UCB-719 Urgent Request for Wages

Erroneously Paid Benefits

If any of these benefit reports are not returned as required, are received late, or contain incorrect/incomplete information, your account will be charged for all benefits erroneously paid as the result of the missing, late or incorrect/incomplete report, including erroneously paid benefits that were originally charged to other employers’ accounts.

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Forms and Reports:

Form UCB-16:

This form is sent to every employer for whom the claimant reported working since the start of his/her base period or since the last claim for UI benefits was filed.

The purpose of this report is:

• to notify the employer that an initial claim application for unemployment benefits has been filed by the claimant;
• to verify the reason the claimant is no longer working for them;
• to verify that the claimant expects to return to work for them (if applicable); and
• to give the employer an opportunity to provide any other information that might affect the claimant's eligibility for unemployment benefits.
  

Form UCB-23:

This form is sent to an employer whenever a claimant reports working for them during a week being claimed or after one week of not reporting wages, vacation, holiday, or dismissal pay if the claimant had previously reported pay with that employer.

The purpose of this report is:

• to confirm that the claimant did work for the UI account identified on the report during the week being claimed;
• to verify the gross amount of wages earned in and other types of income assigned to the specified calendar week;
• to verify the number of hours and minutes for each type of income in the specified calendar week;
• to determine if there was additional work that the claimant could have performed in that week; and
• to give the employer the opportunity to provide any other information that might affect the claimant's eligibility for unemployment benefits.
  

Form UCB-719:

This form is sent to an employer when a claimant files an initial claim application for unemployment benefits and indicates that (s)he was paid by the employer in one or more base period quarters but no wages were previously reported by the employer for the quarters in question.

The purpose of the report is:

• to confirm that the claimant was paid by the employer during the base period quarters in dispute;
• to verify that the wages are reportable to the UI account number listed; and
• to obtain the amount of wages paid in each quarter.

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Updated: December 20, 2017