Forms

EMPLOYERS

LIR#27, Application for Certificate of Compliance with Section 3-122-112, HAR Use this form to request a tax clearance from the Department of Labor & Industrial Relations for Professional Service Awards

UC-1, Report to Determine Liability Under the Hawaii Employment Security Law In most cases, if you have employees working in Hawaii, you must pay unemployment taxes on their wages in this state. Tax reports are due quarterly. Liable employers must submit a tax report every quarter, even if there are no paid employees that quarter and/or taxes are unable to be paid. Future hire dates are not accepted. Hawaii employers are required to register their company online at: https://uiclaims.hawaii.gov/ For general registration information: Oahu: (808) 586-8982 Hawaii Island: (808) 974-4095 Maui: (808) 984-8410 Kauai: (808) 274-3025

UC-B6, Quarterly Wage, Contribution and Employment and Training Assessment Report Hawaii employers are required to file quarterly unemployment insurance tax reports on the new and interactive Employer Website at: https://uiclaims.hawaii.gov

UC-25, Notification of Changes Use this form to terminate your business or make changes to your account information. Form UC-25 can be found online at: https://uiclaims.hawaii.gov

UC-86, Waiver of Employer’s Experience Record Use this form to file for a transfer of reserves in accordance with provisions of Section 383-66(a)(5) of Hawaii Revised Statutes. Form UC-86 can be found online at: https://uiclaims.hawaii.gov

UC-347, Notification of Acquisitions or Transfers Use this form to report acquisitions or transfers in accordance with Section 383-66(b), HRS, if there is substantially common ownership, management or control between employing units or an acquisition or transfer made between an employing unit and a person who is not an employing unit. The department will determine substantially common ownership, management or control. All parties involved in the acquisition or transfer must file the form separately. Form UC-347 can be found online at: https://uiclaims.hawaii.gov

UC175, Application for Self-Financing for Non-Profit Organizations (NPO) Non-profit organizations (religious, charitable, and educations) qualifying for income tax exemption under the Section 501(c)(3) Internal Revenue Code may apply for exemption from paying contributions by requesting self-financing status under provisions of Chapter 383-62(d) of the Hawaii Employment Security Law. Indian tribes or tribal units may elect to be self-financing. Form UC-175 can be found at: https://uiclaims.hawaii.gov

UI CLAIMANTS

UC-161(a) Instructions for Partial and Part-Total Claimant’s Filing on the Web In addition of filing your weekly or biweekly claim certification, your employer must file “Weekly Report of Low Earnings” to verify your earnings, availability for work and continued employment for each week that you claim.

UC-226 Verification of Registration with a Referring Union. If you report that you will obtain work through a referring union, have an authorized union official complete and submit this form to your local claims office within 7 calendar days after filing your claim.

UC-253 Record of Contacts Made for Work

UC-266 Claimant Handbook

UC-275 Request for Withdrawal of Claim

UC-T1 Approved Training Application Form and UC-T2 Certification of Unsatisfactory Progress and Attendance

DUA CLAIMANTS

The forms below are for claimants that are submitting or have submitted an application through https://uiclaims.hawaii.gov. Please be advised that documents submitted without an application will not be accepted and will not qualify as a timely application.

DUA Informational Sheet – Information regarding the DUA program.

ETA 83 – Weekly Request for Assistance– DUA weekly claim certifications. These forms are necessary to be submitted to receive DUA benefits.

Instructions for Completing ETA 83– Instructions on how to complete and submit DUA weekly claim certifications

Questionnaire For Self-Employed Individuals – If you indicated that you are self-employed on your claim application, please submit this form.

UC-BP-155 (DUA) – Statement of Gross Wages/Net Earnings– Provide a record of your wages from employment and self-employment. Additional supporting documentation is also necessary to be submitted.