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                   UI 3/40 Employer’s Contribution and Wage Reporting 

To submit quarterly Contribution and Wage Reports for 2023: 

• Log on to the MyTax Illinois website at http://mytax.illinois.gov to establish your UI account, file your reports, and
  make payments, all electronically. This is preferred!

  Other features available on MyTax Illinois:

                 Request refunds online                    View your new annual tax rates
                 View your tax letters and correspondence  Request interest and penalty waivers
                 Request interest and penalty waivers      Maintain Power of Attorney relationships
                                                             and much more…

• Or, complete and sign the interactive PDF form, and then PRINT and MAIL.
  Don’t forget to fill in your 7-digit UI Account number and your 9-digit FEIN number.

Visit our IDES Employer Update website, at http://mytax.illinois.gov for additional information.  Contact the IDES 
Employer hotline at 1-800-247-4984 if you have any questions about MyTax Illinois or the UI 3/40 form.      
The UI 3/40 Form starts on the next page. 

Revised: March 2023

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            F                                               EMPLOYER’S
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Clear                                                                                                                                                                                                                          Print                                                                                                                                                                      Save

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     This report & payment can be mailed to: IDES, PO Box 19300, Springfield, IL 62794-9300 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          (If less than $2.00 - Send report only)                                            “ILLINOIS DIRECTOR OF EMPLOYMENT SECURITY”   MAKE CHECK PAYABLE TO: 7. TOTAL PAYMENT DUE     6D.   Deduct: Previous Overpayment       6C.   Add: Previous Underpayment PLUS interest       6B.   Add: Penalty for late filing ($50.00 minimum)       6A.   Add: Interest at 2% (.02) per month for late payment        5B.                                                Use this space if TOTAL WAGES ( Rate Determination" or 5.4%.                                                                            calculate at the lessor of your rate as shown on your "Annual Contribution                                                                  5A. If the quarter’s TOTAL WAGES (Line 2) are less than $50,000,     4.                                      year.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      (If no wages were paid, see instructions.) TOTAL WAGES PAID for covered employment                                                                              If none, enter “0”. during or received pay for the payroll period including the 12th of each month of the quarter.                                          ENTER THE TOTAL NUMBER OF COVERED WORKERS
of Attorney must be on file. enterprise. If signed by any other person, a Power officer                                                      This                                          Date                                                                  Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               Title                                                                             Signed                                                                      was or is to be deducted from workers’ wages.     belief; and that no part of the contribution reported           true     this         herebyI                                                                                                                                                                                                                                                                                                                                                                                                                 CONTRIBUTION DUE - Multiply line  4 by                                                                                                                                                                                                                                                                                                                                                                      TAXABLE WAGES (line 2 minus line 3)                                         LESS: Wages in excess of3.                                                                           2.                                                                                                                                                                                                                                                                               1.                                                                                                                                                                             CHANGE IN STATUS                                                                          (If not shown or if incorrect enter correct number) Your Federal Employer Identification Number                                                                                                                                               FOR                                                           FORM UI-3/40      STATE
                                                                                                                                             report                                        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                                                                                                                                           and      report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Also, complete form UI-50A. Check this box to indicate that you no longer have workers in Illinois and want your account terminated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          CONTRIBUTION
                                                                                or                                                                                                                                                                                                                                                                                                                                                      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                                                             correct               certify                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1ST MONTH________________2ND MONTH_________________3RD MONTH______________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ACCOUNT NUMBER                                                      9999999
                                                                                                                                             MUST                                                                                                                          (                                                                                                                                                                                                                                                                                                                                                                   and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         OF
                                                                                authorized                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               ILLINOIS
                                                                                                                                                                                                                                                                           CODE                                                            AREA                                                                                                                                                                                                                                                                                       to       in           that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       IMPORTANT — SEE INSTRUCTIONS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ILLINOIS
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                             be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       the      all                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Rev. 
                                                                                agent                                                        signed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   best     accompanying the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    If a change has occurred in the status of your business, complete form UI-50A.
                                                                                within                                                                                                                                                                                     )                                                                                                                                                                                                                                                                                                                                                          of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          3/                                                                    Department of Employment Security
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            information                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             $13,271 
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(See Instructions)                                                                                                                           by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       my                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   L           ine 2) are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            YR/QTR                                                          00/0
                                                                                the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            schedules    contained                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       per covered worker per calendar                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       3CONTRIBUTION RATE
                                                                                                                                             owner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   knowledge
                                                                                employing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   AND
                                                                                                                                             partner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               your rate.                                         $50,000                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   L10ZZ-2006                                                                                                                                             
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    PERIOD ENDING
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               is           in                                                                                                                                                                                                                                                                                                                                                                                                                                                                         or more this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         WAGE
                                                                                                                                                      including penalties and/or interest.   may                                                                 result                                                                 provide       of                                                                    3200.       purpose                                                           are                                                     information                                               This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
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                                                                                                                                                                                             result                                                              in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         quarter.
                                                                                                                                                                                                                                                                                                                                                                                                                                        as
                                                                                                                                                                                                                                                                 this                                                                   information                                                                         Disclosure                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
                                                                                                                                                                                             in                                                                                                                                                                                                                                         outlined                                                                                                                  and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     DUE AFTER ABOVE DATE         PENALTY ($50.00 MIN.)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                REPORT
                                                                                                                                                                                             statutorily                                                         form                                                                                                                                                                                                                                                                                                                                                       is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     00-0000000
                                                                                                                                                                                                                                                                                                                                                      are                                                                                                                                                 to                                                      payment                                                   requesting
                                                                                                                                                                                                                                                                                                                                                                                                                            of
                                                                                                                                                                                                                                                                 not                                                                    or            REQUIRED.                                                             information under                                                             accomplish
                                                                                                                                                                                             prescribed                                                          being                                                                  pay
                                                                                                                                                                                                                                                                                                                                                                                                                                        820                                                                                                                       of
                                                                                                                                                                                                                                                                                                                                        contributions                                                                                                                                                                                                             contributions                                             both
                                                                                                                                                                                                                                                                 processed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                AFTER ABOVE DATE
                                                                                                                                                                                                                                                                                                                                                                                                                            and         ILCS                                                              the                                                                                                               disclosure                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 INTEREST DUE
                                                                                                                                                                                             sanctions,                                                                                                                                               Failure                                                               payment     405/100-                                                          statutory                                                                                                                                                     . .                                       .                                                                                     .                        .                      . .                                  . . . .                                              . . . .                                                   . . . .                                                          . . . .                                       .                      .                    .                            .                                                                                                                                                     .                                                                                                                                 . . .                                   . .      .                                                      .  .                            . .                                          .  .
                                                                                                                                                                                                                                                                 and                                                                    may                                                                                                                                                                                                                       that
                                                                                                                                                                                                                                                                                                                                                      to                                                                                                                                                                                                                                                                    of
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  (Enter all nine numbers, without hyphens)       8.                                   must file electronically.                                                                   this form. If the employer has 25 or more employees, the employer                                                                                                                                   Employers that
                                                                                1.1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   000                                                                         Worker’s Social Security N
                                                                                                                                      Total
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
                                                                                                                                                                                                                                                                 :                                                                                    :                                                                                 :                                                                           :                                                                                                                 :                     :           :                                                                                                                               :                                             :                                      :   :                                                  :                                                       :   :                                                              :    :                                                                                  :                                                                                                                                                                                                                                                                                                                    :   :                                            :                                                           :                            :                                                                                  :                                                                            :                                                                                                                                                                                                    :   :                                                                                                                                                                                                                 :                                                               :                                           :                                                                              : : : : : : :      :
                                                                                                                                      Wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           00                                                                                                                                                                                                                                                                                                             
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
                                                                                                                                                                                                                                                                 :                                                                                    :                                                                                 :                                                                           :                                                                                                                 :                     :           :                                                                                                                               :                                             :                                      :   :                                                  :                                                       :   :                                                              :    :                                                                                  :                                                                                                                                                                                                                                                                                                                    :   :                                            :                                                           :                            :                                                                                  :                                                                            :                                                                                                                                                                                                    :   :                                                                                                                                                                                                                 :                                                               :                                           :                                                                              : : : : : : :      :                                                                                                                                                                                                                                                                                                                                                                                                                       have
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0000                                                                   
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             umber
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             less than 

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  , initial                                                                                                                                                                                                                                                                                                                                                                            25
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  , then last                                                                                                                                                                                                                                                                                                                                                                          employees

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    )

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           (Type or Print)                              NAME OF WORKER
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       the
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       option
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Do NOT staple reports or payment.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       of
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             using 

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                                                                                 $. . . . . . . . . . . . . . . . . . . . . . . . . . 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        10.                                                                                                                                                                                                                                                                                                                                          Page No. 1 of_____Pages
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Enter                   Excess of          (Include Wages in                            TOTAL Wages Paid
                                                                                0.00                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Dollars
                                                                                                                                           :                                               :                                                                     :                                                                                                                                                                      :                                                                                                                                                                                             :                                 :                                                                                                                                                                             :                                          :                                                                                                          :                                                                  :                                                                                       :                                                                                                                                                                                                                                                                                                                        :                                                                                                        :                                                                                                               :                                                                                                                                                                                                                                                                                 :                                                                                                                                                                                                                     :                                                                                                           :                                                                                :   :   :          & Cents:        $13,271
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Enlarge image
                                                                                                                         this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  in                                                                                                                                                                                                                                                                                                                                   is                                                                                                                                                                                                           of
                                                                                                                         line.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     the                                                                                                       less
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            have                                    days                                                                                                                                                                                                                                                                                                                                                LATE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 within                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             wages
                          in                                              quarters.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Payments                             month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               included                                                                                                                                                                      from                                                                                                                                                                                                                                                                                                                                                                                        Attorney                                                                                                                                                                                                                                                worker.                                                                                                                                                                                       quarter                                                                  excess
                                                                                                                         on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              at                                                                                                                                                                                                                                                                                                                                                                                                                 thereof                                                                                                                                                                                                                                                                                                                                                                                                                        6C 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            to 
                          excess                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            in
                          2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         thirty                                                                                                                                                                                                                                                                                                                                              FOR                                                                                                                        is                                            amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      of                                                                                                                                                                                                                                                                                                                                                                                                                                                    the                                                          Total 
                                                                          prior                                          amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          interest         day.                                 the                                                                                                                                                                                                                                                                                                                                  whichever                                                                                                                                                                                                                                                                                                                                                                                                                                              and                                                                                                                                                                               agent                                                                                                                                                                                                                                                                                                                                                   each 
                                                                          of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                deemed                                  first                                                                                                                                                                                                                                                                                                                                   fraction                                                                                                                                                                             the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 of                                                                                                                                                                                                                                                                     paid
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           6B, 
                          line                                                                                           net                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             add              per                                                                                                                                                                                                                                                                                                                                                                                               or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Power                                                                                                                                                                                                                                                                                                                                                                                                                                                 during 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          deducted 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            are                                                                                                                                                                                                                                                                                                                                                     month,                              PENALTY                                                                                                                                                                  enter                                                                                                                                                                                                                                     6A,                                                                                                                                                                                                                                                                               a 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            wages
                                                                                                                         the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              2%                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     be                                                                                                                                                                                                                                                                                          authorized                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         performed. 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Number 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          of                date                                                                                                                                                                                                                                                                                                                                                                            $10,000     THE                                                                                                                        underpayment                                                                                                                                                                                                                                                                            Lines 
                          in                                              wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          date,                                                 preceding            For                                                                                                                                                                                                                                                                                                             per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    worker 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 report, 
                                                                                                                         enter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           due                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     may                                                                                                                                                                                                                                                                                                                                                                                         person,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            were 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           plus 
                                                                          excess                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            due                month                                                                                                                                                                                                                                                                                                                                                        each        less.                                                                                                                                                                    this                                                                                                                            line                                                                                                                                                                                                                                                                                        officer                                                                                                                                                                                                                                                                                                                                                 Security                                                                                                                                                                                      each 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    $2,500 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            the                the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         5B                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               non-taxable
                                                                                                                         2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               interest         at                                                        (Exception:                                                                                                                                                                                                                                                                                                     or                      for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              other                                                                                                                                                                                                                                                                                                                                                                                                                                                 to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               UITaxRates
                          included                                                                                       and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              12/365                                                                                                                                                                                                                                                                                                                                                                                                        is                                                                                                                         previous                                      for                                                                                                                                                                                                                                       or 
                                                                          include                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                this 
                          wages                                                                                          Line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            the                                after                                                                                                                                                                                                                                                                                                                                                                           $10                                                                                                                                    any                                                                                                                                                                                                                                                                                     5A                                                                                                                                                                                partner,                                                                                        any                                                                                                                                                                                                                                                     Social                                                                                                                                                                                                                                                     services    and
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   paid 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 on                                                                                                                                                                                                                                                                                                                                                                                          by 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         by                                                                         received.                                                                                                                                                                                                                                                                                                                                           whichever 
                                                                          not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  day                                                                                                                                                                                                                                                                                                                                  wages                   is                                                                                                                                     for                                                                                                                                                                                                                                                                                     line                                                                     line6D.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     when 
                                                                          Do                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     remittance                                                                                                                                                                                                                                of                                                                                                                                                                                owner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         taxable                                                                                                                                                                                                                                                                                                                                                                                                                                                 /employers/
                          Enter                                                                                          from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             computed          days               last                                                                                                                                                                                                                                                                                                                                 total                                                                                                                                                                                                                                                                                                                                        shown                                                                                                                                                                              on                                                                                                                                                                                                                                                                                                                                                                                                                                                               complete                                                                                                                                                                                      wages                                                        of 
                          -                                                                                              3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               paid                               30                                      was                                                                                                                                                                                                                                                                                                             of                      penalty                                                                                                                                                                              the                                                                                                                                                                                                                                                                                                                                                                                                                         by                                                                                              signed 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         not              month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    payment                                                                                                                                                                                                                                                                                 sum                                                                                                                                                                                                                                                                               If                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             both                                                                                                                                                                                                                                                                                                                                                                                                                                                    ides
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               the                                                                                                                                                                                                                                                                                                                                                                      $5,000,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    total 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Show                                                                                                                                                                                                                                                                                                                                                                                                – Enter the total wages reported in Column 10.                                                                                                                         – To obtain a Historical Table, use the 
                                                     3,271                worker.                                        Line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               than               on                                                                                                                                                                                                                                                                                                                                                                       or                                                                                                                         If                                            with       the underpayment including interest.                                                                                 Credit                                     contribution due this quarter.                                 the                                                                                                                                                                               signed                                                                                                                                                                                                                                                                                                                                                  -                                                                                                                                                                                                                                                                                                            $13,271.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   -                                                                                                                                                                                                                                                                                                                                                                amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          per                                                                                                                                                                                                                                                                                                                                                                       thereof                                                                                                                                                                                                                                                                                                                                      - 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    payment 
                                                                          for                                            -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               contributions    of                                   received             the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    -                                                                                                                                                                                                                                                                                 enterprise.                                                                                                                                                                                                                                                                                                                 - Type or print the workers’ names.                                                                                       - Enter                                                      regardless  include                            of 
                                                                          each                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              more                                                                                                                                                                                                                                                                                                                                                                            maximum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          be 
                                                                                                                         Deduct                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           2%                                                                                                                                                                                                                                                                                                                                                                                                            wages                                                                                                                                                                                                                                                                                                                                                                                                              Enter                                                                    any                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             .illinois.gov/
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Number                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              must 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    fraction                            total                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        SS 
                                                                                                                                                  Complete only one, whichever is applicable.                                                                           5A - If the quarter’s total wages are less than $50,000, calculate at the                                                                                                   lessor of your rate as shown on your "Annual Contribution Rate      Determination" or 5.4%.                                                                         5B - If the quarter’s total wages are $50,000 or more, calculate at the                 rate shown on your "Annual Contribution Rate Determination".                             On               rate              received           been                 which       past the due date, interest is computed on a daily basis.)                                                    On  reports  filed  after  the  penalty  date,  the  penalty  is  $5  for  each  $10,000                                                                                              or                      less.       of                                            FILING CAN IN NO INSTANCE BE LESS THAN $50.
                                                                          taxable                                                                 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      -                                                                                                                                                                                                    -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              report                                                                                          employing 
                                                                                                                                                     
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             This                                                                                            the                                                                                          must be on file.                                                                                                                                           Worker’s 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             -                                                                                                                                                                                                                                                                                                                                                                                                                           Name of Workers                                                                                                           Total Wages Paid
                          Less Wages in Excess of $1                      $13,271                                        Taxable  Wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Interest                                                                                                                                                                                             Penalty                                                                                                                                                                                                                                                                                                                                              Previous Underpayment                                                                                                                                                         Previous Overpayment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         8.                                                                                                                                                                                                                                                                                                                                                                                         Total Wages for this Quarter
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Total Payment Due
                                                                                                                         4.
                                                                          the 
                          Line 3.                                         of                                             Line                     Line 5A and 5B                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Line 6A.                                                                                                                                                                                             Line 6B.                                                                                                                                                                                                                                                                                                                                                          Line 6C.                                                                                                                                                                  Line 6D.                                                                                         Line 7.                                                                                                                                                                           Signature                                                                                                                                                                                                                                                                                                                                                        Column                                                     Column 9.                                                                                                                 Column 10.                                                                                                                                                                       Line 11.                                                                                                                                                                                   For historical Illinois UI Tax Rates                                                                                                                 following link: http://www

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     is                                                                                                                                     of
                                                           and                         your                                                                                                                                                                                                                                                                                                                                                                                                                        Act.                                                                                                                                                                                                                                                                                                            not                                   for                            give                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       part                                                                                                                                                                                                                                                                                                                                                                    pay,
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        made,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Wages
                                                                                       for                  provided                                                                                                                                                                                                                                                                                                                                                                                                                               quarter;                                                                                                                                                                                                                                                                        has               showing                                                                                                                                                                                                                                                                                                                                                  though                                                                                                             report.                                                                                                                                                                                                                  omitted                           it                                                                                                                                              Illinois                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      received                                     reported              sick 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        and                                                                                                                                                                                                                                                                                                                                                                                                                                               Revenue                                                                                                                                                                                                                                                                                                                                                                           in                                                                                                                                                                                                                                                                                                                                                                                    which                                                                              and                                                 month                                                                                                     vacation
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
            through the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  liability                                                                                                                                                                                                                                                                                                                            even                                                                                                                                                                                                                                                                                                              unchanged.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             employment                                         year.                        tips 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             be subject                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              (full 
                                                                                       a PIN                                                                                                                                                                                                                                                                                                                                                                                                                                                       of the                                                                                                                                       and remittances                                                                                                                    but                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    and/or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            received pay for             each  more  than                                                                                          on                                                                                                                                                                                                        prizes, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 quarter’s                                                                                                                                                                                                                                                  whether                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       already
                                                           taxable wages 
            payment                                                                                         clients are                                                                                                                                                                                                                                                                                                                                                                                                                            end                                                                                                                                                                                                                       will                                                                    a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Section,                                                                                                                                                                                                                                                                                                                                                                          workers                                                                                                                                                                                                                                                                                                                                                                               website                                                                                                                                of 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             pay, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              quarterly 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Protested”                                                                                                                                                                                                                                                                                                                                                                                                                                        Line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            have
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   quarter,  report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      . For more information,                                                                                                                                                                            report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   workers                                                                                                                                                       those                                                                                               covered                                            calendar                     bonuses; 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   and
                                                           your                        contain                                                                                                                                                                                                                                                                                                                                                                                                                                                     the                                                                                                                                          Reports                                                                      date                                                                    file                contesting                                                                                                                                                                                                                                                                                                                                                                                                                                              current                                                                                                                                                                                                                                                                                                                                                                                                    have                                                                                                                                                                                                                                                                                                                                                                                  our                                                                                                                                    12th                                                                                                                                                                                                          for                                                the 
            your                                                                                            your                                                                                                                                                                                                                                                                                                                                                                                                        contribution payment                                                                                                                                                                                                                                                                                       a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Hot                                                                                                                                                                                                                               the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   at                                                                                                                                     the                                                                                                                                                                                                                                              who                                          and 
                                                                                       not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      31.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              the                                                                                                                                                                                                                      underreported                                                                                                                                                                     longer                                                                                                                                                                                                                                                                                                                                                                                                                                                                   covered                                                                                                                                                       year                                                                                                                                                                                                      vacation 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        the                                                                                                                                                                                                                                                  that                                                                    must                                               “Liability                                                                                                                                                                                                                                                                                            (UI-3/40)                                                                                                                                                                                                                                                                                                                                                                     on 
            make                                                                                            assist                                                                                                                                                                                                                                                                                                                                                                                                                                 following                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     on                                                                                                                                                                                                                       are                                                                                                                                                                               no                                                                                                                                                                                                                                                                                                                                                                                                                                                                       of                                                                                                                                                                                                                                                                quarter                                            during 
                                                                                       does 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   during                                employer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            pay, 
            and  calculate                                                                                  to                                                                                                                                                                                                                                                                                                                                                                                                          and                                                                                                                                                                     January                                                                      after                                                                                                                                                                                                                                                                                                                                                                                                                            report                                                                                                                                      Employer                                                                                                                                                                                                                          note                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  obtained                                                                                                                                                                                                                                                                                                                                             the                                workers
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            you 
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   month 
            report  will                                                               this                                                                                                                                                                                                                                                                                                                                                                                                                             filed,                                                                                                                                                                  and                                                                                                                                wages             employer,                                                                                                                                                                                                                                                                                                                                                                                                                                                                   quarters                 the                                                                                                                                                                                                                                                                                                                                                                               that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   $13,271             commissions 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        wage                                                                                                                                                                                                                                                                                                                                                                          Please 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        be                         of                                                                                                                                           31                                                                                                                                 no                an                                                                                                                                                                                                                                                                                                                                                                                                                                                                          prior                    from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       total                  performed services during or                                                                                                           the                                                                                                                                                    of                                                 separation 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  can                                                                                                                                                                                                                                                                                                                                                  paid                               paid
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           after completing all items and signing the report.                                                                                                                                                                                                 and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   in
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             postmarked 
                                                                                                            MyTax                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Quarter”.                                                                                                                                                                                                                                                                                                                                                                                                                                               for                      form                                                                                                                                                                                            whenever                                                                                                                                                                          indicate                                                                                                                                                                                                                                                                                                                                                                                                          and should be attached to your report.                 the                    who                                                                                                                                                                                                                                                                                                                        salaries, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  forms                                                                                                                                  payroll period including
            quarterly  which                                                           preparer,  Illinois                                                                                                                                                                                                                                                                                                                                                                                                              must                       day                                                                                                                                                                                                                       or                                                    paid              being                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  quarter.                                                                                                                                        to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     paid sick leave. Exclude workers on strike.                         wages                              wages           excess 
                                                           application,                                                                                                                                                                                                                                                                                                                                                                                                                                                                            last                                                                                                                                         October                                                                                                                                                                  This                                                                              report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         filed                             a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Enter                  time)                        the                                                    the  quarter.  Include  workers  who  have  earned         $13,271                 or                                                                  all                                                in                           (a) 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    An employer who paid no wages during a quarter, but has not 
            your                                                                                            Illinois                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            31,                                                                                                                                who                                                                                                                     the                                                                                                                                                                                                                                                contribution                                                                                                                                                                                                                                                                                                                                                                  for                                                                                                                                             box 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          proper                                                                                                                                                                                          be 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        report                     the                                                                                                                                                                                                                                                                                               ceased              Paid  contributions  should of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           These                                                                              -                                                                                                                                                                                                                                                                                                                                                                       the 
            file                                           Illinois  tax                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     delivered                                                                                                                                                                     on                                                                                                                                                                                                                                                 the                                                                                                                adjustments              the                                                                                                                                                                                                                                                                                                                                                                               this                                                                                                                                                                                                                                                                                                                                                                                   
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Enter                              including       wages                        include  employer; to                                                            payments on account of retirement; (b) the reasonable cash value of remuneration paid other than cash, such as goods, meals and lodging, and (c) any remuneration for services performed within the State which is considered wages under the Federal Unemployment Tax Act.                           NOTE:                                                                  permanently ceased being an employer, must file a report showing                              “No Wages Paid This Quarter”.
            may                                                                        you  are a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             file                                                                                                               no                                                                                                                              be corrected even if the contribution for the quarter remains                            Should                            wages                          Supplemental or Amended Report.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             -
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        and/or interest. 
                                                           MyTax                       If                   for using                                                                                                                                                                                                                                                                                                                                                                                                   original                                                                                                                                                                30, July                                                                                                                           employer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               -                                                                                                                                                                                 Check            and  want  your  account  terminated.    For  a  change  in  status,  a  change            in  business  address  or  if  you  no  longer  have  workers  in  Illinois,  please             complete  form  UI-50A.    If  you  want  some  of  your  correspondence  to  be mailed  to  a  special  address,  please  complete  the “Special  Mailing”  form        UI-1M.                      www.ides.illinois.gov
            -   the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                quarterlyThe                 by eachno laterApril                                                                                                                                                                                                         employerpersonally thanpenalty            subject toAn                  thepermanently      Illinois“No WagestheUnemploymentthepaymentreasonInsurancemust                                                                                                                                                                                                                                                                                                                                                                                           Make                     Request                        Division,pleaseshould                                                                                                                             visit the33"ContactSouthIDES" page on theStateIDES website.-                                                                                                                                                      Street,Reporting errorsChicago, Illinois 60603 
            You 

                                                                                       due.                                              website.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             -                                                                                                                                                                                                                                                                                                                             LINE ITEM INSTRUCTIONS FOR PREPARATION OF UI-3/40 REPORT
                                                                                                                                                                                              INSTRUCTIONS
                                                                                                            Instructions 
      Illinois                                                                                                IDES                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   No. of Covered Workers                                                                                                                                                                                                                                            Total Wages Paid
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              contributions 
      MyTax                                                internet using              contribution         client.                      on the                                               GENERAL                                                                                                                                             Filing Reports  -  The  Employer’s Contribution and Wage Report, IDES Form UI-3/40, must be filed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Nonprofit organizations and local government entities which elected to make payments in lieu           of                     contributions are not required.                                                                          Adjustments                                                                                                                                                                                                               Supplemental Report                                                                                                                                                 Change in Status                                                                                                                                                                                                                                                                                                                                                                                                                                                         Line 1.                                                                                                                                                                                                                                                                           Line 2.






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