Forms and Publications for Employers

The following forms are in Portable Document Format and require Adobe Acrobat Reader (version 7 or above recommended) to view, print and save. Click the button below for a free download of the most current version of the Adobe Acrobat Reader.

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Posters

• Notice To Workers Concerning Unemployment Benefits (MODES-B-2)
  • Download the Poster
  
  
• Spanish Version - Notice To Workers Concerning Unemployment Benefits (MODES-B-2-S)
  • Download the Poster
  
  
• Importance of Filing Reports/File Quarterly Reports When Due (MODES-INF-394)
  • Download the Poster

Brochures

• Unemployment Insurance Facts (MODES-INF-149)
  • Download the Brochure
  
  
• Employers' Rights and Responsibilities (MODES-INF-151)
  • Download the Brochure
  
  
• Employer Benefit Charges (MODES-INF-280)
  • Download the Brochure
  
  
• Shared Work Program for Employers (MODES-INF-301)
  • Download the Brochure
  
  
• Shared Work Program for Employees (MODES-INF-300)
  • Download the Brochure
  
  
• Who Are Employees? (MODES-INF-310)
  • Download the Brochure
  
  
• Obtaining Information from Division of Employment Security Records (MODES-INF-326)
  • Download the Brochure
  
  
• Payroll Records Required By Law (MODES-31)
  • Download the Brochure
  
  
• Unemployment State Tax Automated Reporting - USTAR pamphlet (MODES-INF-395)
  • Download the Brochure
  
  
• Information for Appeals Tribunal Hearings - Unemployment Benefits (MODES-INF-166)
  • Download the Brochure

Forms

• Taxpayer Power of Attorney Form (MODES-4444)
  • Download the Form (Microsoft Word format)
  
  
• Employer Records Release Authorization (MODES-4385)
  • Download the Form
  
  
• Application For Review (MOIC-L-6)
  • Download the Form
  
  
• Register for an account number
  • Online Business Registration for New Employers <-- Register for Business Taxes Here
  • Report to Determine Liability Status (MODES-2699-5)
    • Download the Form (Microsoft Word format)
    • Download the Instruction
    • See a Description
  
  
• Importance of Filing Reports/File Quarterly Reports When Due (MODES-INF-394)
  • Download the Form
  
  
• Report that a business has stopped employing workers, or the closure, sale or partial sale of a business
  • Internet USTAR <--Report Change in Business/Employment Here
  • Report on Change of Business Operations (MODES-9)
    • Download the Form
    • See a Description
  
  
• Report wages and tax for a quarter
  • Internet USTAR <--File Quarterly Report Here
  • Quarterly Contribution and Wage Report (MODES-4-7)
    • Download: Quarterly Contribution and Wage Report Spreadsheet * This is an Excel fillable form. For a blank printable form, use the following bullet point.
    • Download the Form - this form is a "print only" form.
    • Download the Instruction
    • See a Description
  
  
• Report wages when there are too many workers to fit on the Quarterly Contribution and Wage Report
  • Quarterly Wage Report Continuation Sheet (MODES-10B)
    • Download: Quarterly Wage Report Continuation Sheet * This is an Excel fillable form. For a blank printable form, use the following bullet point.
    • Download the Form - this form is a "print only" form.
    • See a Description
  
  
• Adjust wage and tax totals or wages of individual workers that were, or should have been, previously reported
  • Internet USTAR <--File Adjustment Request Here
  • Contribution and Wage Adjustment Report (MODES-4A)
    • Download the Form
    • See a Description
  
  
• Social Security Number Correction (MODES-4427)
  • Download the Form
  • See a Description
  
  
• Common Paymaster Law (MODES-4337)
  • Download the Form
  
  
• Common Paymaster Application (MODES-4338)
  • Download the Form
  • See a Description
  
  
• Electronic Reporting
  • Magnetic Media Reporting Specifications (MODES-INF-368)
  • Transmittal of Quarterly Wages reported on Magnetic Media (MODES-4260)
  
  
• Termination of Coverage Application (MODES-6)
  • Download the Form. (Microsoft Word format)
  • See a Description
  
  
• Voluntary Payment Work Sheet (MODES-2272)
  • Download the Form.

Forms for Lessor Employing Units

• Assignment and Escrow Agreement (MODES-4251)
  • Download the Form
  • See a Description
  
  
• Surety Bond (MODES-4252)
  • Download the Form
  • See a Description
  
  
• Lessor Employing Units Regulation (MODES-4281)
  • Download the Form
  
  
• Quarterly Client List (MODES-4282)
  • Download the Form
  • See a Description
  
  
• Lessor Employing Unit/Client Lessee Law (MODES-4267)
  • Download the Form
  • See a Description
  
  
• Irrevocable Letter Of Credit (MODES-4354)
  • Download the Form
  
  
• Authorization For Release Of Confidential Information (MODES-4354-3)
  • Download the Form
  
  
• Irrevocable Letter Of Credit Regulation (C-248)
  • Download the Form

Forms for Consumer Directed Services Vendors

• Quarterly CDS Vendor Consumer List (MODES-4590)
  • Download the Form