PART 9 - Benefit Reports and Forms Sent to Employers
Unemployment Insurance Handbook for Employers (UCB-201-P)
Section 1 - Benefits
Your help is needed to maintain the integrity
of the Unemployment Insurance program. One way we solicit your assistance is by sending you
reports that either ask for verification of information provided by the claimant, ask for
additional information, or provide information to you about the status of the claim.
As mentioned in Part 5 - Benefit Reports Required by the Department, there are
three required unemployment benefit reports.
In addition to the three required reports, there are a number of other forms that you may
receive.
When you receive one of our forms, please review it
promptly. Complete and return all those that you are required to return or that ask for
information. The reverse side of most forms will include an explanation of the report,
instructions for completion, and/or telephone numbers to call for more information. If you
find an error on any of the informational reports, notify us as soon as you can so that we
can investigate the discrepancy and correct the record.
Remember that your account will be charged for all
erroneously paid benefits as the result of a missing, late or incorrect/incomplete
required report and if you fail to provide correct and complete information
requested during a fact-finding investigation, including erroneously paid benefits that were charged to other
employers' accounts.
Make your business name and address associated with your UI account number
clear to your employees. Claimants select the employer(s) they worked for when they file for unemployment. Supplying your business name and address associated with your UI account to your employees helps ensure forms get to you in a timely manner and helps prevent erroneous payments.
Employers covered under Wisconsin Unemployment Insurance law are also required to file quarterly
tax and wage reports as explained in
Section 2 - Tax and Section 4
- Wage Reporting. These reports are used to determine the correct amount of base period wages paid to a claimant. Your account will be charged for any erroneously paid benefits that result from missing, late or incorrect/incomplete information on a Quarterly Wage Report.
SCANNING OF UI FORMS
Form UCB-16, Separation Notice, and Form UCB-23, Wage Verification/Eligibility Report, use automated scanner processing.
Please use the following guidelines when completing these forms:
- Use blue or black ink;
- Mark all check boxes with an X;
- Print numbers clearly;
- Stay inside the designated boxes;
- The scanner cannot read information outside the boxes. If you
need to provide additional information, please attach a separate piece
of paper.
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A. FORM UCB-16, SEPARATION NOTICE
If all of the information on Form UCB-16 is correct and there are no eligibility issues or
non-work payments that apply to the claim, the report does not have to be returned.
If any information on Form UCB-16 is incorrect or there is any eligibility issue or
non-work payment that applies to the claim, provide detailed information regarding the eligibility issue or non-work payment and
return this report by the due date.
1 & 2 Employer's UI Account Number
-
Your UI account number should be printed here. If it is missing or incorrect, enter the
correct number in the box provided.
-
If you do not have an account number, enter "no number assigned" in the
box
provided.
-
If the claimant did not work for you, place an "X" in the box
provided.
3 Date Last Worked and Expected Recall
-
The date shown on the form is the Saturday date
of the calendar week during which the claimant reported last working for you. If the
correct last day of work falls in a different calendar week (Sunday through Saturday),
please show the correct actual last day of work in the box provided.
-
The second paragraph will only appear if the claimant reported
that (s)he expects to return to work for you by the Saturday week ending date printed on the form. If this is
incorrect, place an "X" in the box provided.
4 Reason for Separation
- The reason for separation provided by the claimant when (s)he filed this claim for benefits is shown here. If the reason shown is incorrect, indicate the correct reason for separation in the box provided. Provide detailed information regarding the separation. Attach a separate piece of paper for any supporting details and/or documentation and return by the due date. If you choose not to provide details regarding the separation, X the box on the bottom of the form and return it immediately.
5 Other Eligibility Issues
-
If there are any other eligibility questions that apply to
the claim, report them in the box provided. Some common eligibility issues are listed on the reverse
of Form UCB-16 under the explanation of this item. Also refer to Part
7 for a brief explanation of several common
eligibility issues.
-
Provide details about the eligibility issue being reported
in the box provided. Attach a separate piece of paper for any supporting documentation you want considered.
6 Vacation, Dismissal or Holiday Pay for Days/Weeks after the Last Day of Work
-
If vacation, dismissal or holiday pay has been assigned to days
or weeks after the claimant's last day of work, this pay should be
reported here. See Part 6 for more information
about when these types of pay can be treated as wages and should be reported.
- Show the type of pay, the week ending date(s) that the pay is assigned to, the gross amount of the pay and the hours and minutes for each week in the boxes provided.
-
When reporting holiday pay, show both the holiday and
the date; i.e.
Christmas - December 25
Personal holiday - May 15
7 Signature, Date and Telephone Number
-
Sign and date the form.
-
Provide the name and telephone number (including area codes)
of a person who can be contacted during regular business hours if additional information is
needed.
8 Date Report is Due
-
Every Form UCB-16 will have a due date, however the report only
needs to be returned if the
reason for separation given by the claimant or any other information on the report is
incorrect, or if there is any other eligibility issue or non-work payment that applies to
the claim. Return the report as soon as possible to prevent erroneous payments. The report
must be received by the department by the due date to be considered timely.
9 Where to Return the Report
-
If the report must be returned, please reply via one
method only: online, fax, or mail:
- To reply online, use
https://dwd.wisconsin.gov/ui/sides. You must have a Wisconsin UI Account to
reply online. Report hours and minutes of vacation, dismissal/severance, and holiday pay online in
an electronic attachment or under Separation Comments. More information about replying online is available
at https://dwd.wisconsin.gov/ui/sides.
- To reply by fax, use the fax number shown on the report.
- To reply by mail, send to the address shown on the report.
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B. FORM UCB-23, WAGE VERIFICATION/ELIGIBILITY REPORT
If all of the information on Form UCB-23 is correct and there are no eligibility issues that
apply to the claim, the report does not have to be returned.
If any information on Form UCB-23 is incorrect or there is any eligibility issue
that applies to the claim, provide detailed information regarding the eligibility issue and
return this report by the due date. Refer to the following instructions for completion of a Form UCB-23 that must be returned.
EXAMPLE FORM: Example of UCB-23, Wage Verification/Eligibility Report
CAUTION: Any benefits improperly paid because you failed to question eligibility on Form UCB-23
in a timely manner will be charged to your account even if a later protest is raised on a
form UCB-16 that is returned timely.
1 & 2 UI Account Number, Name, & Address
-
If the UI account number, name or address
listed for your company is incorrect, write in the correct information
in the box provided.
-
If no account number is printed on the report, enter your account number or write
"no number assigned" in the box provided.
-
If the claimant did not work for you, place an "x" in the box provided.
3 Wages and Other Income for the Week
-
Review the wages and/or pay the claimant reported for the specified calendar week.
-
If any amount of wages or other income is incorrect, the form must be returned with the
correct amount(s). You must return the report to correct the wages/pay even if the
difference appears to be insignificant. Even a small difference between the wages reported
by the claimant and the amount actually earned can affect the amount of benefits payable
for the week.
-
Be sure to report all types of wages/pay for the week in the spaces
provided, even for those that the claimant reported correctly. If one of
the spaces is left blank, we will assume that the claimant did not receive the wage or
income identified by that space.
-
See Part 6 for the definition of benefit year wages and when
other types of income can be treated as benefit year wages.
4 Hours and Minutes for the Week
-
Review information reported by the claimant about hours/minutes
for each pay type in the specified
calendar week.
-
If the claimants information is incorrect, the form must be returned with the
correct amount of hours and minutes You must return the report to give us the correct
hours/minutes even if the difference appears to be insignificant.
-
Include only hours/minutes of actual work.
5 Additional Work Available
-
If the claimant was asked or scheduled
to work more hours than (s)he did work place an "X" in the box
provided.
-
If no, do not complete the rest of this section.
-
If yes, enter the number of additional hours
available, the rate of pay that would have been paid for such
work, the date(s) when the work was available and the total amount of additional wages the claimant could have earned in the
boxes
provided.
6 Eligibility Issues
7 Signature, Date and Telephone Number
-
Sign and date the form.
-
Provide the name and telephone number (including area code) of a person who can be
contacted during regular business hours if additional information is needed.
8 Date Due
-
Form UCB-23 must be received by the department by the due
date shown on the report to be considered timely.
9 Where to Return the Report
-
If your report must be returned, either send it to the
address or FAX it to the number shown on the report. Please do not do both.
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C. FORM UCB-719, URGENT REQUEST FOR WAGES
Form UCB-719 must always be returned, even if the claimant did not work for you or you believe the
claimant is not eligible.
1 Due Date
-
This is the date your report is due. The same wage
information requested by this report is also requested from the claimant. If your report
is not received by the department by the due date, benefits will be paid based on the
claimants records.
2 UI Account Number
-
This is the UI account number identified as the
employer for whom the claimant worked and for which wages are missing. Refer to the
instructions for completing the quarterly wage chart when the claimants wages were
or should have been reported to a different UI account number.
- If the wages you paid the claimant in the quarter were reported to a different UI Account # than the one
shown on the report, write "wages reported to (correct UI Account #)".
- If the claimant did not work for or with you in any capacity, check the box that says "Not Our Employee."
3 Quarterly Wage Verification and Eligibility Issues Chart
- The quarters printed in the quarterly wage chart are the quarters that are included in the claimant’s base period.
- For quarters where some wages have already been reported to Wisconsin for this UI account #, the wages have already
been entered in the "Gross Wages Reported" column. If these amounts are incorrect, please show the correct amount
in the "Correct Gross Wages" column.
- For quarters where no wages have previously been reported, make the following entries:
- Enter the total gross wages paid in each quarter in the Correct Gross Wages column.
- If the claimant was your employee but was not paid wages in the quarter, enter
"0.00" in the Correct Gross Wages column.
- If the wages you paid the claimant in the quarter were reported to a different state, enter the wages and mark
"X" in the box to the right in the "Reported to Another State" column. Provide any relevant details in Part 4: Explanation of Eligibility Issues.
- If payments were made to the claimant but you considered him/her to be an independent contractor or self-employed, mark
"X" in the box to the right in the "Independent Contractor" column. Provide any relevant details in Part 4: Explanation of Eligibility Issues.
- If the wages you paid the claimant in the quarter were for work performed in excluded employment, enter the wages and mark
"X" in the box to the right in the "Excluded Employment" column. Provide any relevant details in Part 4: Explanation of Eligibility Issues.
- If you are a successor in a business transfer, do not duplicate wages already reported by your predecessor for this UI account #.
- You must raise all eligibility issues that you were aware of as of the date this form was mailed to you.
4 Informational Messages
-
This space is used to give you any unique information or
instructions that you may need to complete a particular Form UCB-719.
-
If you are a successor in a business transfer involving this
UI account, a message will be printed in this area to remind you not to duplicate wages
already reported for the claimant by your business predecessor.
5 Claimant's First and Last Days
of Work
-
Enter the month/day/year of the claimants first day of
work and last day of work for you in the base period.
6 Signature, Date and Telephone Number
-
Sign and date the form.
-
Provide the name and telephone number (including area code)
of a person who can be contacted during regular business hours if additional information is
needed.
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D. FORM UCB-20, DETERMINATION
Form UCB-20 is used to notify claimants and
employers of the results of a fact-finding investigation conducted to resolve issues of
benefit eligibility and/or entitlement. See Part 7 for detailed
information about common eligibility issues and the investigative procedure.
You can view determinations (UCB-20) online using SIDES E-Response. More information is available at
https://dwd.wisconsin.gov/ui/sides.
If you
receive one of these determinations, you are considered the employer party of interest.
The employer party of interest is the employer whose interests may be adversely affected
by the decision.
Review the findings and effect of the decision. If you believe the
facts are wrong or that the deputy has improperly applied the law, you may request a
hearing. The request for a hearing (appeal) must be received or postmarked by the
department by the date specified on the determination. See
Section 3
for more information about the appeal process.
1 Claimant Name, Address and Social Security Number
-
The name and social security number of the claimant who is
affected by the determination are shown here.
-
The determination is mailed to the most current address on
file for the claimant.
2 UI Account Number
-
This is the employer UI Account number of the employer party
of interest to the determination being made.
-
If the number is incorrect, call the Employer Assistance Line at (414) 438-7705 immediately so we can correct the record.
3 Employer Name and Address
-
The determination is mailed to the most current
official name and address of record for the UI Account number listed.
4 Issue Week and Week Ending
-
The earliest UI calendar week affected by the determination
is printed in this area. (Note: UI calendars have the UI
week numbers printed next to each calendar week, see
https://dwd.wisconsin.gov/uiben/calendars.htm.)
-
All UI weeks end on Saturday. This is the Saturday of the UI
week number identified above.
5 Applicable Wisconsin Law
-
The statute of the unemployment law and/or administrative
rule upon which the determination is based is printed here.
6 Findings and Determination of the Deputy
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The legal conclusion reached by the department deputy is
printed first.
-
A brief statement of the facts which support the legal
conclusion follow.
-
The actual impact on the UI claim and the employer UI
account is summarized under the "Effect".
-
The effect will indicate whether benefits are payable, or
will ever be payable, from the UI account shown on the determination.
-
The effect also specifies periods of disqualification,
whether erroneous benefits have been paid as a result of the determination and if so, who
is at fault for the erroneous payments.
7 Deputy
- The code number used to identify who investigated the issue and made the determination.
8 Date Mailed
-
The date the determination was delivered to the
U.S. Post Office for delivery.
9 Appeal Date
-
The date by which a timely appeal must be postmarked if
mailed or received if faxed or submitted online.
How and Where to File an Appeal
You can appeal benefit determinations online using SIDES E-Response. More information is available
at https://dwd.wisconsin.gov/ui/sides.
Information about filing an appeal is printed on the back of the determination. If you want to
request a hearing, use one of the following options:
- To appeal online, use https://dwd.wisconsin.gov/ui/sides.
- To appeal by fax, use the fax number listed on the determination.
- To appeal by mail, send to the hearing office address listed on the determination.
The hearings office will process your appeal and can answer any questions you have about the hearing.
Use this address and fax number for appeals only.
Who to Contact for More Information
If you would like more information about the
determination or have other questions about the benefit claim, contact our
Help Center. The address, fax, and Employer Assistance Line number are printed
on the back of the determination. Do not send your request for a hearing to the
Help Center.
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E. FORM UCB-29, NOTICE OF BENEFIT CHARGING
This notice is sent to you whenever the claimant indicates that (s)he quit working for you and the subsequent work
requalification requirement was satisfied before the application for unemployment benefits
was made.
1 UI Office
-
The address of the Help Center handling the
claim and the telephone number to call if you have questions about the notice.
2 UI Account Number
-
The account number of the employing unit identified as the
employer from whom the claimant quit.
3 Employer Name and Address
-
The official name and address of record for the UI account
number listed are printed directly below the number.
4 Claimant's Name and Social Security Number
-
The name and social security number of the
claimant affected by the notice.
5 Week in which the Claimant Quit
-
The quit is assumed to have occurred during the week that includes
the last day of work reported by the claimant. The week ending date
that includes the claimant’s last day of work is printed here, along
with the corresponding UI calendar week number. (Note: UI calendars
have the UI
week numbers printed next to each calendar week, see
https://dwd.wisconsin.gov/uiben/calendars.htm.)
- If the claimant quit in a different week, notify the
department immediately.
6 Notice of Benefit Charging
-
This section informs you whether or not the UI Account
identified will be liable for benefits based on work performed prior to the quit.
-
The accounts of "contributing or taxable"
employers are not charged for such benefits.
-
"Reimbursable" employers, federal employers and
out-of-state employers are billed for such benefits.
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F. FORM UCF-350, WEEKLY EARNINGS REPORT
Form UCF-350 is used to obtain the employer's certification of gross wages earned. All wages reported must be gross wages, hours and minutes for each pay type. Wages includes all non-work payments (bonuses, tips, incentives, overtime, sick pay or any other supplements). Report each type of pay in its own column. While used as part of our fraud control initiatives, our requesting this information does not necessarily imply that the claimant failed to report work or wages properly.
1 The top section of the report includes the following claim information:
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Address, phone number and fax number of the UI adjudicator
requesting the information.
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Official name and address of record of the employer for whom
the claimant may have worked or is working.
-
Date report was sent to you.
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Name and social security number of the employee for whom
wages are being verified.
-
The UI account number of the employer listed.
2 The letter includes:
-
Instructions for completing the report.
-
Date by which the department is requesting the completed
report be returned.
-
Any special instructions or information that may help you
complete the report.
3 & 4 Completing the Report:
-
Please complete the entire bottom portion of the form.
-
Provide all of the information requested in the top portion
of the chart regarding the claimants current or former status with your company.
- The beginning date (Sunday) and ending date (Saturday) of each calendar week for which wages are being verified, as well as the corresponding UI calendar week number, will be printed on the bottom portion of the chart. You are asked to report the gross earnings for each week listed and the date they were paid. You
are asked to report gross earnings, hours and minutes for each week
listed.
-
Be sure to include wages for all work performed in the week,
as well as any other wages assigned to the week, such as vacation, holiday or dismissal
pay.
-
If your company does not use a Sunday through Saturday
calendar week payroll, you must adjust your figures to the calendar week dates
shown.
-
Enter "NONE" in the space for each week in which
there were no wages earned and/or for which no pay was assigned.
5 Certification:
-
Be sure to sign and date the report and provide a
telephone number where we can reach you during regular business hours if additional
information or clarification is needed.
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G. FORM UCB-701, COMPUTATION OF UNEMPLOYMENT INSURANCE BENEFITS
Form UCB-701 lists employees who have established claims based on work with you.
The information entered on the front of the form is obtained from the wage data you submitted
quarterly. If you did not file a quarterly report, either your Form UCB-719, Urgent
Request for Wages, or the claimant's affidavit of earnings was used to determine the
claimants potential entitlement.
1 UI Account Number
-
This is the UI account that is potentially liable for
unemployment payments based on the claims established during the report period.
2 Report Period
-
This is the time period that the report covers.
All claims established during this period, for which the UI account listed on the report
is potentially liable, are included on the report.
3 Employee/SS Number
-
The names and social security numbers for each
claim established during the report period are printed in this column.
4 Liability Information
-
Total Maximum - This is the
maximum amount of regular benefits potentially payable tot he
employee, and it is the maximum amount that may be charged to
your account. In some situations, such as a voluntary quitting
or a discharge for misconduct, these benefits may be charged to the
balancing account or to the administrative account and not to your
UI reserve account. You will receive a written determination
if these situations apply.
-
Weekly Maximum - The amount
shown is the weekly maximum that could be charged to your
account. If the employee had other employers in the base
period, the amount shown is your proportional share of each week
paid. The proportion potentially chargeable to you is based on
the percentage of base period wages paid by you in relation to base
period wages paid by all other employers.
-
Liable Until - The date the
employee's benefit year ends is shown here. Benefits based on
this computation cannot be carried over to a later benefit year.
5 Quarterly Gross Wages
-
The liability information in the prior column is based on
the wages paid by you in the base period quarters of the claim. The
gross wages paid by this UI account in each quarter of the
employee's base period are shown.
6 Eligibility Pending
-
If there are eligibility issues yet to be resolved against
your account, there will be an asterisk in this column. Actual payment of benefits will
not be made until the investigations for such eligibility issues have been completed and
you have been mailed written determinations (Form UCB-20) resolving the issues.
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H. FORM UCB-708, NOTICE OF CHANGED LIABILITY FOR UI BENEFITS
Form UCB-708 notifies employers
of reduced liability when the resolution of a benefit year issue changes the claimant's
remaining entitlement.
1 UI Account Number
-
This is the UI account whose liability for listed claims has been
changed by decisions issued during the report period.
2 Report Period
-
This is the time period that the report covers. All
claimants whose entitlement from the listed UI account is changed by a decision issued
during this period are included on the report.
3 Employee's Name/Social Security Number
-
The names and social security numbers of all
claimants whose entitlement from the UI account shown was changed by a decision issued
during the report period are printed in this column.
4 Liability Remaining
-
The first column lists the total potential entitlement
remaining against the UI account number shown on the report before the decision was issued
that changed the claimants entitlement
-
The second column shows the total potential entitlement
remaining from the UI account shown on the report after the decision that changed the
claimants entitlement was issued.
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I. FORM UCF-17275, WAGE/EARNINGS AUDIT
Form UCF-17275 is used to audit the wages
earned by certain claimants during a quarter in which they claimed and were paid UI
benefits. It is used to prevent fraud and abuse by ensuring that the payments made to the
claimant were proper.
-
Please reply via one method only: online, fax, or
mail:
Updated: April 23, 2024