Uia 1718 Template

Uia 1718 Template

The UIA 1718 form is a crucial document used by individuals in Michigan to report discrepancies in their unemployment wage records. This form allows claimants to contest reported wages or to inform the Unemployment Insurance Agency if wages were not reported at all. Completing the UIA 1718 accurately is essential for ensuring that unemployment benefits reflect the correct earnings; take the first step by filling out the form below.

Table of Contents

The UIA 1718 form is an essential document for individuals navigating the unemployment benefits process in Michigan. This form, known as the Claimant’s Statement of Wages, is designed for those who need to contest the wages reported by their employers or address situations where wages have not been reported at all. It plays a critical role in ensuring that claimants receive the correct amount of unemployment benefits based on their actual earnings. The form requires claimants to provide detailed information about their employment, including the names of employers, types of work performed, and gross wages for specific quarters. Additionally, it emphasizes the importance of submitting clear proof of wages, such as pay stubs or W-2 forms, to support any claims made. Completing the UIA 1718 accurately and promptly can significantly impact the outcome of a claimant's benefits, making it crucial for individuals to follow the provided instructions carefully. This form not only serves as a means of rectifying wage discrepancies but also acts as a safeguard for the integrity of the unemployment benefits system.

Uia 1718 Sample

UIA 1718

 

 

 

Reset Form

(Rev. 09-21)

 

 

 

 

 

 

 

STATE OF MICHIGAN

GRETCHEN WHITMER

DEPARTMENT OF LABOR AND ECONOMIC OPPORTUNITY

GOVERNOR

UNEMPLOYMENT INSURANCE AGENCY

 

 

 

 

Mail Date:

 

 

 

 

 

 

 

 

 

 

Letter ID:

 

 

 

 

CLM:

 

 

 

 

Name:

Authorized by

MCL 421.1 et seq.

SUSAN R. CORBIN

DIRECTOR

 

Claimant’s Statement of Wages

Employers are required to report quarterly wages for each employee to the Unemployment Insurance Agency (UIA). A claim for unemployment benefits is based on these reported wages. You were sent a Monetary Determination that provided information regarding your claim for unemployment benefits. This monetary determination showed you the wages reported by your employers and/or informed you that an employer(s) did not report wages for you.

This Form UIA 1718, Claimant’s Statement of Wages, must be completed by you if either you disagree with the wages reported by an employer or an employer did not report wages for you at all. Carefully read and follow the directions to complete this form. Mail to the Unemployment Insurance Agency, P.O. Box 169, Grand Rapids, MI 49501-0169 or Fax at 1-517-636-0427.

Check the reason you are completing this form:

Wages earned with _________________________________that I included on my claim for unemployment

Name of Employer

benefits were not included in the calculation of my Monetary Determination.

I disagree with the wages reported by ______________________________ as shown on my Monetary

Name of Employer

Determination.

I never worked for or was not paid by _______________________________ as shown on my Monetary

Name of Employer

Determination and to request the reported wages not be used. Complete Section E only.

Section A - Claimant Information

____________________________________________

_________________________________

First and Last name

 

Social Security Number

Section B - Employer Information

 

____________________________________________

_________________________________

Name of Company or Business

 

Owner/Employer Name

____________________________

_________________________

___________________________

Telephone Number

UIA Employer Account Number

Federal Employer Identification Number (FEIN)

____________________________________________________________________________________________

Address

City

State

Zip Code

Section C - Employment Information

 

 

 

Physical location of your employment: _____________________________________________________________

Type of work you performed or your job title: ________________________________________________________

*017182109*

UIA is an equal opportunity employer/program.

 

UIA 1718 (Rev. 09-21)

How were you paid?

Cash Check

Direct deposit

Letter ID:

Other - explain: ____________________

Was there other remuneration (e.g. bonuses, commissions, 401K, room and board, etc.) in your wages?

No

Yes - explain:

Were deductions made from your pay (e.g. FICA, income taxes, etc.) in your wages?

No

Total gross wages during current calendar year: $____________________

actual

Total gross wages during preceding calendar year: $__________________

actual

Were there other employees?

No

Yes - how many? ______________

 

Is the employer still operating?

No

Yes

 

Additional comments:

 

 

 

Yes

estimated

estimated

Section D - Quarterly Wage Information

You must report the quarterly gross wages (before taxes) on the chart on the next page. There are four calendar quarters per year. The quarters are numbered and are the same from year to year. Each quarter contains three calendar months as follows:

1st Quarter

January 1

through

March 31

2nd Quarter

April 1

through

June 30

3rd Quarter

July 1

through

September 30

4th Quarter

October 1

through

December 31

The involved quarters are the same quarters that are shown on your Monetary Determination under the heading “Monetary Determination Calculations”. Label the chart on the next page with the same quarter dates.

If you are completing this form because wages earned with an employer that you included on your claim were not used in the calculation of your Monetary Determination, complete all quarters that contained wages from that employer.

If you are completing this form because you disagree with the wages reported by your employer, complete only the quarters that you disagree with.

If your address changes, it is important to update it with the Unemployment Insurance Agency.

If you have questions, you may contact us through your MiWAM account or by calling 1-866-500-0017. For telephone or Local Office hours of operation, visit www.michigan.gov/uia. TTY service is available at 1-866-366-0004.

UIA 1718

Letter ID:

 

(Rev. 09-21)

 

These quarterly charts allow you to enter wage information per week to help you determine your quarterly total wages. If you know your gross wages for each quarter, complete only the Total Quarterly Wage box for each involved quarter. Wages are reported in the quarter they are paid to you.

Example: You may have worked during the last week of March (1st quarter), but you were not paid until April (2nd quarter). These wages must be reported in the 2nd quarter (the quarter containing the date you were PAID).

You are required to send in clear, legible proof of wages to support the information you provide on this form. This can include check stubs, W-2s, payroll records, or a letter from the employer with payroll information. Proof of wages must be included in the order for the Unemployment Insurance Agency to use the information you are providing.

Quarter ___

Year ______

Quarter ___

Year ______

Quarter ___

Year ______

Quarter ___

Year ______

Quarter ___

Year ______

WEEK PAID

GROSS WAGES

WEEK PAID

GROSS WAGES

WEEK PAID

GROSS WAGES

WEEK PAID

GROSS WAGES

WEEK PAID

GROSS WAGES

PAID

PAID

PAID

PAID

PAID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

TOTAL

 

TOTAL

 

TOTAL

 

TOTAL

 

Quarterly

 

Quarterly

 

Quarterly

 

Quarterly

 

Quarterly

 

Wages

 

Wages

 

Wages

 

Wages

 

Wages

 

 

 

 

 

 

 

 

 

 

 

Section E - Certification Statement

Certification: I certify that the information I have reported is true and correct. I understand that if I intentionally make a false statement, misrepresent facts or conceal material information, I may be required to pay damages and could be subject to criminal prosecution.

_____________________________________________________

_______________________

Signature

Date

*017182109* UIA is an equal opportunity employer/program.

 

Document Attributes

Fact Name Details
Form Purpose This form is used by claimants to report discrepancies in wages reported by employers to the Unemployment Insurance Agency (UIA).
Governing Law The form is governed by Michigan Compiled Laws (MCL) 421.1 et seq.
Submission Method Claimants can mail the completed form to the UIA or fax it to the provided number.
Wage Reporting Employers must report quarterly wages for each employee, which are crucial for determining unemployment benefits.
Certification Requirement Claimants must sign a certification statement confirming that the information provided is true and correct.

Uia 1718: Usage Instruction

Completing the UIA 1718 form is an important step if you believe there are discrepancies in the wage information reported by your employer or if you did not receive credit for wages you earned. Once you fill out this form, you will need to submit it to the Unemployment Insurance Agency for review. This process is crucial for ensuring your unemployment benefits are calculated accurately.

  1. Check the Reason for Completing the Form: At the top of the form, indicate why you are submitting it by checking the appropriate box. You can choose from three options based on your situation.
  2. Fill Out Section A - Claimant Information: Provide your first and last name, followed by your Social Security Number.
  3. Complete Section B - Employer Information: Enter the name of your employer or the business owner, their telephone number, UIA Employer Account Number, Federal Employer Identification Number (FEIN), and the full address, including city, state, and zip code.
  4. Provide Employment Information in Section C: Describe the physical location of your employment and your job title or type of work performed. Indicate how you were paid (cash, check, direct deposit, etc.) and whether you received any additional remuneration. Note any deductions made from your pay and report your total gross wages for the current and preceding calendar years.
  5. Complete Section D - Quarterly Wage Information: Fill out the chart with your gross wages for each quarter of the year. Make sure to label the quarters according to the dates provided. Report wages based on when you were paid, not when you worked.
  6. Gather Proof of Wages: Collect any necessary documentation to support the information you provided, such as check stubs, W-2 forms, or payroll records. Ensure these documents are clear and legible.
  7. Sign and Date Section E - Certification Statement: Sign the form to certify that all information is true and correct. Include the date of your signature.
  8. Submit the Form: Mail the completed form to the Unemployment Insurance Agency at P.O. Box 169, Grand Rapids, MI 49501-0169 or fax it to 1-517-636-0427.

Frequently Asked Questions

  1. What is the purpose of the UIA 1718 form?

    The UIA 1718 form, also known as the Claimant’s Statement of Wages, is designed for individuals who wish to contest the wages reported by their employers to the Unemployment Insurance Agency (UIA). It is also used when an employer has not reported any wages for the claimant. Completing this form is essential for ensuring that the correct wage information is considered when determining eligibility for unemployment benefits.

  2. Who needs to complete the UIA 1718 form?

  3. How do I fill out the UIA 1718 form?

    To complete the UIA 1718 form, follow these steps:

    • Provide your personal information in Section A, including your name and Social Security Number.
    • In Section B, include details about your employer, such as the company name and contact information.
    • Section C requires information about your employment, including the type of work performed and how you were paid.
    • In Section D, report your quarterly wages based on the calendar year and the specific quarters indicated in your Monetary Determination.
    • Finally, sign and date the certification statement in Section E, affirming that the information provided is accurate.
  4. What should I do if I disagree with the wages reported by my employer?

    If you disagree with the wages reported by your employer, you should complete the UIA 1718 form, specifically indicating your disagreement in the designated section. Ensure that you provide clear evidence to support your claim, such as pay stubs or other relevant documentation. This evidence will help the UIA assess your case accurately.

  5. What if my employer did not report any wages for me?

    If your employer did not report any wages, you must complete the UIA 1718 form and specify this in the appropriate section. Provide as much detail as possible regarding your employment and any wages you believe you earned. It is crucial to include supporting documentation to substantiate your claim.

  6. How should I submit the completed UIA 1718 form?

    You can submit the completed UIA 1718 form by mailing it to the Unemployment Insurance Agency at P.O. Box 169, Grand Rapids, MI 49501-0169. Alternatively, you may fax it to 1-517-636-0427. Ensure that you keep a copy of the submitted form for your records.

  7. What types of documentation do I need to include?

    When submitting the UIA 1718 form, it is essential to include clear and legible proof of wages. Acceptable documentation may include:

    • Pay stubs
    • W-2 forms
    • Payroll records
    • A letter from your employer containing payroll information

    This documentation supports the information you provide on the form and is necessary for the UIA to process your claim accurately.

  8. What if I have questions about the UIA 1718 form?

    If you have questions regarding the UIA 1718 form or the unemployment benefits process, you can contact the UIA through your MiWAM account or by calling 1-866-500-0017. Additionally, you can visit the UIA website at www.michigan.gov/uia for more information and resources.

  9. What happens after I submit the UIA 1718 form?

    After you submit the UIA 1718 form, the Unemployment Insurance Agency will review the information and documentation provided. They will assess your claim and may reach out for additional information if necessary. You will receive a notification regarding the outcome of your claim and any adjustments made to your Monetary Determination.

  10. Is there a deadline for submitting the UIA 1718 form?

    While specific deadlines may vary, it is crucial to submit the UIA 1718 form as soon as possible after receiving your Monetary Determination. Timely submission ensures that your claim is processed efficiently and that you receive the benefits to which you may be entitled without unnecessary delays.

Common mistakes

Filling out the UIA 1718 form can be a straightforward process, but many people make common mistakes that can lead to delays or issues with their unemployment benefits. One frequent error is not providing accurate personal information. Claimants often overlook the importance of ensuring their name and Social Security number are correct. A simple typo can lead to significant complications in processing your claim.

Another mistake involves the employer information section. People sometimes forget to include the correct name of their employer or fail to provide the employer's Federal Employer Identification Number (FEIN). This information is crucial. If the Unemployment Insurance Agency cannot match your claim with the correct employer, it may result in a denial of benefits.

Many individuals also struggle with the quarterly wage information. A common error is reporting wages in the wrong quarter. Remember, wages should be reported in the quarter they were actually paid, not when they were earned. This misunderstanding can cause discrepancies that complicate your claim.

Additionally, some claimants neglect to include supporting documentation. The UIA requires proof of wages, such as pay stubs or W-2 forms. Failing to attach this documentation can lead to delays or even denial of your claim. Always remember to provide clear and legible proof to support the information you submit.

Finally, individuals sometimes skip the certification statement at the end of the form. This section is essential, as it confirms that the information provided is true and correct. Forgetting to sign and date this section can result in your form being rejected. Always double-check that you have completed every section, including the certification.

Documents used along the form

The UIA 1718 form is a critical document for individuals seeking unemployment benefits in Michigan. When completing this form, there are several other forms and documents that may also be required or helpful in the process. Understanding these additional documents can assist claimants in navigating their unemployment claims more effectively.

  • Monetary Determination Letter: This letter is sent by the Unemployment Insurance Agency (UIA) and outlines the wages reported by employers. It serves as the basis for determining eligibility and the amount of benefits. Claimants should carefully review this document to ensure that all reported wages are accurate.
  • W-2 Form: The W-2 form is provided by employers and details the total wages earned by an employee during the previous year, along with any taxes withheld. This document is essential for verifying income and can help clarify discrepancies in wage reporting when completing the UIA 1718 form.
  • Pay Stubs: Pay stubs are issued by employers and show the amount of wages earned during each pay period. They provide a detailed breakdown of earnings and deductions. Claimants can use pay stubs as proof of income when submitting the UIA 1718 form, particularly when disputing reported wages.
  • Employer Verification Letter: This letter can be obtained from an employer and should confirm employment details, including wages and hours worked. It can be particularly useful if there are disputes regarding wage reporting or if an employer has failed to report wages altogether.

By gathering these additional documents, claimants can strengthen their cases and ensure that their unemployment claims are processed accurately. Each document plays a unique role in clarifying employment history and wage information, which is essential for receiving the correct benefits.

Similar forms

  • Form W-2: Similar to the UIA 1718, the W-2 form reports an employee's annual wages and the taxes withheld. Both documents are essential for verifying income for unemployment claims.
  • Form 1099-MISC: This form is used to report income earned by independent contractors. Like the UIA 1718, it provides a record of earnings that can be disputed if incorrect.
  • Monetary Determination Letter: This letter outlines the wages reported to the UIA. The UIA 1718 can be used to contest the information provided in this letter.
  • Employer Verification Letter: A letter from an employer confirming employment details. It serves a similar purpose as the UIA 1718 by validating wage claims.
  • Pay Stubs: These documents show the details of each paycheck. They support the claims made in the UIA 1718 by providing evidence of wages earned.
  • Quarterly Wage Report: Employers submit these reports to the state. They contain wage data that can be compared with the information provided on the UIA 1718.
  • Form 1040: The annual income tax return includes total income earned. This form can be referenced to verify the income reported on the UIA 1718.
  • Employment History Record: This document outlines a person's employment history. It can help support claims made in the UIA 1718 regarding discrepancies in reported wages.

Dos and Don'ts

When filling out the UIA 1718 form, it is crucial to approach the task carefully. Here are five things you should and shouldn't do to ensure your submission is accurate and complete.

  • Do read the instructions thoroughly. Understanding the requirements of the form will help you provide the necessary information without missing any details.
  • Don't leave any sections blank. Each part of the form is important. Incomplete forms can lead to delays in processing your claim.
  • Do provide accurate wage information. Ensure that the wages you report match your actual earnings to avoid complications later.
  • Don't submit unclear or illegible documents. If you are providing proof of wages, make sure all documents are readable. This will help the agency process your information without confusion.
  • Do double-check your contact information. Make sure your address and phone number are correct. This ensures that the agency can reach you if needed.

Following these guidelines will help streamline the process and improve the chances of a successful claim for unemployment benefits.

Misconceptions

Misconceptions about the UIA 1718 form can lead to confusion and mistakes in the unemployment benefits process. Here are eight common misconceptions, along with clarifications to help you better understand this important document.

  • The UIA 1718 form is only for those who have been denied benefits. This is incorrect. The form is used by anyone who disagrees with reported wages or needs to clarify wage information, regardless of their benefits status.
  • You do not need to provide proof of wages. In fact, you are required to submit clear and legible proof of wages, such as check stubs or W-2s, to support the information on the form.
  • Only employers can report wage discrepancies. This is a misconception. Claimants can also report discrepancies by completing the UIA 1718 form if they believe the reported wages are inaccurate.
  • The form is only relevant for the current calendar year. This is not true. You must report wages for both the current and preceding calendar years if applicable.
  • You can submit the form at any time without consequences. While you can submit the form whenever necessary, delays in reporting discrepancies can affect your benefits. It’s important to act promptly.
  • All employers report wages accurately. Unfortunately, this is not always the case. Employers may fail to report wages or may report them inaccurately, which is why the UIA 1718 form exists.
  • Completing the form is optional. It is not optional if you disagree with the wages reported or if wages were not reported. Completing the form is essential for resolving wage-related issues.
  • Submitting the form guarantees that your benefits will be adjusted. While submitting the form is a necessary step, it does not guarantee that your benefits will change. The Unemployment Insurance Agency will review the information provided and make a determination.

Understanding these misconceptions can help you navigate the unemployment benefits process more effectively. Always ensure that you provide accurate information and necessary documentation when completing the UIA 1718 form.

Key takeaways

Filling out the UIA 1718 form is an important step in ensuring that your unemployment benefits are accurately calculated. Here are key takeaways to keep in mind:

  • Understand the Purpose: This form is necessary if you disagree with the wages reported by your employer or if your employer did not report wages at all.
  • Read Instructions Carefully: Follow the directions provided on the form to ensure that you complete it correctly.
  • Provide Accurate Information: Fill in your personal details, including your name and Social Security number, accurately in Section A.
  • Include Employer Details: In Section B, provide complete information about your employer, including their name and contact details.
  • Report Quarterly Wages: In Section D, report your gross wages for each relevant quarter. Ensure you understand the quarterly breakdown.
  • Attach Supporting Documents: Include clear proof of wages, such as pay stubs or W-2 forms, to support your claims.
  • Check Your Work: Before submitting, double-check all entries for accuracy to avoid delays in processing.
  • Submit Promptly: Mail or fax the completed form to the Unemployment Insurance Agency as soon as possible to avoid any issues with your claim.

By following these guidelines, you can help ensure that your unemployment benefits are calculated fairly and accurately. If you have questions, don't hesitate to reach out for assistance.