UI-28 Refund Request Form 

IDES has updated your refund options. You can now receive your refund 

                    either through direct deposit or as a paper check. 

     The best way to submit your UI-28 Refund Request to IDES is online 
                                 through MyTax Illinois. 

To submit your UI-28 Refund Request online: 

         • Log on to the MyTax Illinois website at http://mytax.illinois.gov

         • Click on the Unemployment Insurance link

         • Click on the “Request a Refund” link under the “I Want To” section

         • It’s quick and easy to do

Other features available online at MyTax Illinois: 

         ✓ Submit your quarterly contribution and wage reports
         ✓ Make all your payments easily and securely
         ✓ View your tax letters and correspondence
         ✓ Request interest and penalty waivers
         ✓ View your new annual tax rates
         ✓ Maintain Power of Attorney relationships

               and much more… 

Visit our IDES Employer Update website, at www.ides.illinois.gov/MyTaxUI for 
additional information. Contact the IDES Employer Hotline at 1-800-247-4984 if you 
have any questions about MyTax Illinois or the UI 28 form. 

Instructions for completing the UI-28 are on Page 2. The UI-28 Form is on Pages 3 
and 4. Note, Page 4 is only required if you have elected to receive your refund via 
Direct Deposit. 

UI-28 Revised: April 2022 
Page 1of 4 

                             INFORMATION AND GENERAL INSTRUCTIONS 

If there is currently an overpayment on your account, you may apply the overpayment to contributions due in 
subsequent quarters or we will automatically apply it to any future underpayment. You may also apply for a refund 
online at mytax.illinois.gov or by completing this UI-28 form and faxing it to 217-557-1948 or mailing it to: 

                                   DEPARTMENT OF EMPLOYMENT SECURITY 
                                               REFUND UNIT, 10TH FLOOR 
                                               33 SOUTH STATE STREET 
                                               CHICAGO, ILLINOIS, 60603 
You have three years from the date of the overpayment to use the credit or to request a refund, except in the case of an 
overpayment that occurred on or after January 1, 2015 and prior to the effective date of House Bill 2699 of the 100th 
General Assembly, in which case you have until June 30, 2018 or 3 years from the date of the overpayment, whichever is 
later. 

If you are adjusting individual worker’s wages not previously corrected, you must complete Form UI-40C “EMPLOYERS 
CORRECTION REPORT FOR THE QUARTERENDING -                            ,” and submit it with the Form UI-28. TheUI-40C 
form may be printed from the IDES website, www.ides.illinois.gov. Please be aware that correcting a wage report may 
affect an employer’s contribution rate for any year with respect to which such wages were included in the computation 
of the rate. 

All claims for adjustments/refund are subject to field investigation and audit at the discretion of the Director. 

                                       INSTRUCTIONS FOR PREPARATION OF 
                                       FORM UI-28, REFUND REQUEST FORM 

Enter your name and account number exactly as it appears on your contribution report. Enter your current address. 
However, entering an address on this form that is different than the address currently contained in our records will not 
be considered an official change of address request. If this is a new address, you must update your address with the 
Department in one of the following ways: through MyTax Illinois (mytax.illinois.gov), by mailing a UI-50A Notice of 
Change to the Department, or by calling, faxing or writing the Department and providing the same information as would 
be provided on the UI-50A. 

ITEM A. BASIS OF CLAIM 
       Explain in detail the nature of the overpayment. State fully the facts which you believe entitle you to an 
       adjustment/refund. If more space is required, continue on your own letterhead, which will then become a part 
       of this claim. FAILURE TO GIVE COMPLETE INFORMATION WILL DELAY THE PROCESSING OF YOUR CLAIM AND 
       MAY RESULT IN A DENIAL. 

ITEM B. DESCRIPTION OF PAYMENTS 
       Enter the date of payment, original amount of payment and amount to be refunded. 
Total Amount of This Claim  –Enter the total amount of claim for the calendar year. Amount shown in this item must 
equal the sum of the totals in the Amount to be Refunded column. 

                       *** The UI-28 must be Signed with Official Title and Dated *** 

UI-28 Revised: April 2022 
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                             Refund Request Form (UI-28) 
                             33 South State Street, Refund Unit, 10th Floor 
Fax: 217-557-1948            Chicago, Illinois, 60603 

UI Account Number 

Employer Name 

Mailing Address 

City - State - Zip Code - Phone Number  

         A. BASIS FOR CLAIM. (If more space is required, attach additional sheets)

         B. DESCRIPTION OF PAYMENTS. Please list the payments for which a refund is requested below:

               DATE OF PAYMENT  ORIGINAL AMOUNT OF PAYMENT  AMOUNT TO BE REFUNDED 

                             TOTAL AMOUNT OF THIS CLAIM: 

               Your refund may be sent to you either in the form of Direct Deposit or a Paper Check. 
                       If you choose Direct Deposit, complete page 4 and return it with this page 3. 

Payment Method (Select One):            Direct Deposit                            Paper Check 

I, the undersigned, certify that the information contained in this claim, including any other attachments, is true and 
correct to the best of my knowledge and belief, that I have authority to act on behalf of the abovenamed employer, 
and that no claim for this erroneous payment has previously been made. 

Printed Name                                          Signed by 

Official Title                                        Date 

Note: This claim for refund must be signed by an owner, partner, officer or authorized agent within the 
employing enterprise. If signed by another person, a Power of Attorney must be on file. This state agency is 
requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under 820 
ILCS 405/2201. Disclosure of this information is voluntary. However, failure to supply the information required by 
this form will result in your refund request being denied. 

UI-28 Revised: April 2022
Page 3of 4 

                           Direct Deposit Authorization 
               (Complete and return with Page 3 only if electing Direct Deposit) 

Employer Name:     

Employer UI Account Number (7 Digits): 

If Direct Deposit is Chosen, Please Provide the Employer’s Bank Information Below 

         Employer FEIN Number (9 Digits): 

                           Bank Name: 

               Bank Routing Number: 

               Bank Account Number: 

         Bank Account Number (Re-enter): 

               Name on Bank Account: 
               Type of Bank Account:         Business Checking  Checking 

                           (Select Only One) Business Savings   Savings 

Printed Name                                 Signed by 

     If you elected to receive a Paper Check, fax only Page 3 to the fax number below. 

               If you elected Direct Deposit, fax both Pages 3 and 4 (in that order) 

                           to the fax number below. 

                           Fax:  217-557-1948 

UI-28 Revised: April 2022  
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