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                      UI 3/40 Employer’s Contribution and Wage Reporting 

To submit quarterly Contribution and Wage Reports for 2024: 

• 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 
                       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…

• 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: February 2024

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   F                                               EMPLOYER’S
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Clear                                                                                                                                                                                                                          Print                                                                                                                                                                      Save

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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       (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.                                                3.                                                                    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
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    TAXABLE WAGES (line 2 minus line 3)                                          (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
                                                                                                                                                 report                                        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                                                                                                                                           and      report                                                                                                                                                                                                                                                                                                                                                                                                                               CONTRIBUTION DUE - Multiply line  4 by                                                                                                                                                                                                                                                                                                                                                                                                                        LESS                                                                                                                                                                                                                                                                                                                                                                                               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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         IMPORTANT                                                                                             1ST MONTH________________2ND MONTH_________________3RD MONTH______________                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        ACCOUNT NUMBER                                                      9999999
                                                                                    authorized                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                 MUST                                                                                                                          (                                                                                                                                                                                                                                                                                                                                                                   and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       OF
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ILLINOIS
                                                                                                                                                                                                                                                                               CODE                                                            AREA                                                                                                                                                                                                                                                                                       to       in           that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              ILLINOIS
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
                                                                                                                                                 be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       the      all                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Rev. 
                                                                                    agent                                                        signed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   best     accompanying the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   excess                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                If a change has occurred in the status of your business, complete form UI-50A.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                information                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     SEE INSTRUCTIONS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2/
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      of 
                                                                                    within                                                                                                                                                                                     )                                                                                                                                                                                                                                                                                                                                                          of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   L           ine 2) are                                                                                                                                                                                                                                                                                                                                                                                                 $13,590                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           YR/QTR                                                          00/020062                                                                                                                       202                                                                                    Department of Employment Security
(See Instructions)                                                                                                                               by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       my
                                                                                                                                                 owner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   knowledge
                                                                                    the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            schedules    contained                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               4CONTRIBUTION RATE
                                                                                                                                                 partner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               your rate.                                         $50,000                                                                                                                                                                                                                                                                                                                                                                                                    per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   L10ZZ-2006                                                                                                                                                                         
                                                                                    employing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      AND
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         covered                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           PERIOD ENDING
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   is           in                                                                                                                                                                                                                                                                                                                                                                                                                                                                         or more this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            WAGE
                                                                                                                                                          including penalties and/or interest.   may                                                                 result                                                                 provide       of                                                                    3200.        purpose                                                          are                                                     information                                               This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
                                                                                                                                                                                                                                                                                                                                                          contributions                                                                                                                                       necessary                                                                                                         agency                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                worker                                                                                                                                                                                                                                                                                                                                                 (full and part time) who performed services                                                                                                                                                                                                                                L09ZZZZZZZ                                                                                                                                                                                                                                                                                                                                             
                                                                                                                                                                                                 result                                                              in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         quarter.
                                                                                                                                                                                                                                                                     this                                                                   information                                                                         Disclosure   as
                                                                                                                                                                                                 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
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
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                                                                                                                                          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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                                                                                     $. . . . . . . . . . . . . . . . . . . . . . . . . . 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Enter Dollars & Cents:            Excess of          (Include Wages in                                              10.                                                                                                                                                                                                                                                                                                                                          Page No. 1 of_____Pages
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               TOTAL Wages Paid
                                                                                0.00
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             $13,590
                                                                                                                                               :                                               :                                                                     :                                                                                                                                                                      :                                                                                                                                                                                             :                                 :                                                                                                                                                                             :                                          :                                                                                                          :                                                                  :                                                                                       :                                                                                                                                                                                                                                                                                                                        :                                                             :                                                                                                 :                                                                                                                                                                                                                                                                                 :                                                                                                                                                                                                                     :                                                                                                           :                                                                                :   :   :
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   in        )
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      DollarsExcess 



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                           in

                           2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                in                                                                                                                                                                                                                                                                                                                                   is                                                                                                                                                                                                           of
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                                                                        prior                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         at                                                                                                                                                                                                                                                                                                                                                                                                                             LATE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           within                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              wages
                           line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Payments                             month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               included                                                                                                                                                                from                                                                                                                                                                                                                                                                                                                                                                                        Attorney                                                                                                                                                                                                                                                worker.                                                                                                                                        quarter                                                                  excess
                                                                        of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               to                                                                                                                                                                                                                                                                                                                                                                              thereof                                                                                                                                                                                                                                                                                                                                                                                                                  6C 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 thirty                                                                                                                                                                                                                                                                                                                                              FOR                                                                                                                        is                                            amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                in
                                                                                                                                  amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              interest         day.                                 the                                                                                                                                                                                                                                                                                                                                  whichever                                                                                                                                                                                                                                                                                                                                                                                                                                        and                                                                                                                                                                               agent                                                                                           of                                                                                                                                                                                                                                                                                                                                                                                                     the                                                          Total
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            each 
                                                                        wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            deemed                                  first                                                                                                                                                                                                                                                                                                                                   fraction                                                                                                                                                                             the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           of                                                                                                                                                                                                                      paid
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  6B, 
                                                                                                                                  net
                           in                                                                                                     the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 add              per                                                                                                                                                                                                                                                                                                                                                                                               or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Power                                                                                                                                                                                                                                                                                                                                                                                                  during 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    deducted 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         are                                                                                                                                                                                                                                                                                                                                                     month,                              PENALTY                                                                                                                                                                  enter                                                                                                                                                                                                                               6A,                                                                                                                                                                                                                                                                               a 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        be                                                                                                                                                                                                                                                                                          authorized                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      wages
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      date,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Number                                                                                                                                                                                                      performed.
                                                                                                                                  enter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                of                date                                                                                                                                                                                                                                                                                                                                                                            $10,000     THE                                                                                                                        underpayment                                                                                                                                                                                                                                                                      Lines 
                                                                        excess                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2%                                   preceding            For                                                                                                                                                                                                                                                                                                             per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     worker 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              report, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      due                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               may                                                                                                                                                                                                                                                                                                                                                                                         person,                                                                                                                                                                                                                                                                                                                                                                                                                                                             were
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  plus 
                           included                                     include                                                   and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    due                month                                                                                                                                                                                                                                                                                                                                                        each        less.                                                                                                                                                                    this                                                                                                                      line                                                                                                                                                                                                                                                                                        officer                                                                                                                                                                                                                                                                                                                                                 Security                                                                                                                                       each 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 $2,500 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       12/365                                                                                                                                                                                                                                                                                                                                                                                                        is                                                                                                                                                                                                                                                                                                                                                                                                           5B                                                                                                                                                                                                                                                                                other                                                                                                                                                                                                                                                                                                                                                                                                                                                                           non-taxable
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         the                the 
                                                                        not                                                       2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    at                                                        (Exception:                                                                                                                                                                                                                                                                                                     or                      for                                                                                                                                    previous                                      for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          to                                                                                                                                                                                                                                                                                                                                                                                                              UITaxRates
                                                                        Do                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          this                                                                                                      or 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      interest 
                           wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         after                                                                                                                                                                                                                                                                                                                                                                           $10                                                                                                                                    any                                                                                                                                                                                                                                                                               5A                                                                                                                                                                                partner,                                                                                        any                                                                                                                                                                                                                                                     Social                                                                                                                                                                                                      services    and
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           paid 
                                                                                                                                  Line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               on                                                                                                                                                                                                                                                                                                                                                                                          by 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            day                                                                                                                                                                                                                                                                                                                                  wages                   is 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      by                                                                         received.                                                                                                                                                                                                                                                                                                                                           whichever                                                                                                                  for                                                                                                                                                                                                                                                                               line                                                                     line6D.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      when
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    taxable                                                                                                                                                                                                                                                                                                                                /employers/
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            complete 
                           Enter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              remittance                                                                                                                                                                                                                          of                                                                                                                                                                                owner,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 wages                                                        of
                           -                                            worker.                                                   from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 computed          days               last                                                                                                                                                                                                                                                                                                                                 total                                                                                                                                                                                                                                                                                                                                  shown                                                                                                                                                                              on                                                                                                       by                                                                                              signed 
                                                       3,590                                                                      Line                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                not              month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    payment                                                                                                                                                                                                                                                                           sum                                                                                                                                                                                                                                                                               If                                                                                                                                                                                                                                                                                                                                                                                                                                                                              both                                                                                                                                                                                                                                                                                                                                   ides
                                                                                                                                  3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   paid                               30                                      was                                                                                                                                                                                                                                                                                                             of                      penalty                                                                                                                                                                              the 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            the 
                                                                        each                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $5,000,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               total 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Show                                                                                                                                                                                                                                                                                                                             – Enter the total wages reported in Column 10.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         than               on                                                                                                                                                                                                                                                                                                                                                                       or                                                                                                                         If                                            with       the underpayment including interest.                                                                           Credit                                     contribution due this quarter.                                 the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             – To obtain a Historical Table, use the 
                                                                        for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     -                                                                                                                                                                                                                                                                                                                                                          amount                                                                                                   signed                                                                                                                                                                                                                                                                                                                                                  -                                                                                                                                                                                                                                                             $13,590.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       per                                                                                                                                                                                                                                                                                                                                                                       thereof                                                                                                                                                                                                                                                                                                                                - 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 payment 
                                                                        taxable                                                   -                      -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             2%                more                                                                                                                                                                                                                                                                                                                                                                            maximum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     - Enter                                                      regardless  include                            of 
                                                                                                                                  Deduct                 Complete only one, whichever is applicable.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 wages                                                                                                                                                                                                                                                                                                                                                                                                        Enter                                                                    any                                                                                                                                                                                                      enterprise.                                                                                                                                                                                                                                                                                                                 - Type or print the workers’ names.                                                                                                                                                                                                                                                                                                                                                                                                                                                        .illinois.gov/
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      contributions    of                                   received             the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Number                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         2
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        must 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 fraction                            total                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  SS 
                                                                                                                                                                                                     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.
                                                                        $13,590                                                   Wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               -                                                                                                                                                                                                    -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        report                                                                                          employing 
                                                                        the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         This                                                                                            the                                                                                          must be on file.                                                                                                                                           Worker’s                                                            Name of Workers                                                            Total Wages Paid
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    -
                           Less Wages in  Excess of $1                   of                                                       Taxable                Line 5A and 5B                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Interest                                                                                                                                                                                             Penalty                                                                                                                                                                                                                                                                                                                                              Previous Underpayment                                                                                                                                                   Previous Overpayment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         8.                                                                                                                                                                                                                                                                                                                      Total Wages for this Quarter
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Total Payment Due
                                                                                                                                  4.                     line.
                           Line 3.                                      excess                    quarters.                       Line                   this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         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                                                                                                                                                                                                                                                                                                                                                                                                        is 
                                                         and                         your                                                                                                                                                                                                                                                                                                                                                       Act.                                                                                                                                                                                                                                                                                                            not                                   for                            give                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       part                                                                                                                                                                                                                                                                                                                                                                the 
                                                                                                                                                                                                                                                                                                                                                                                                                                                     made, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  already
                                                                                     for                  provided                                                                                                                                                                                                                                                                                                                                                           quarter;                                                                                                                                                                                                                                                                           has               showing                                                                                                                                                                                                                                                                                                                                                  though                                                                                                             report.                                                                                                                                                                                                            omitted                           it                                                                                                                                              Illinois                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      pay,                                                                                                                                                     which 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     and                                                                                                                                                                                                                                                                                                                                                                                                                                               Revenue                                                                                                                                                                                                                                                                                                                                                                     in                                                                                                                                                                                                                                                                                                                                                                                    which                                                                              and                                                 month                                                              on                                                                                                                                                            bonuses;                                                                       (b)  cash, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
            through the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               liability                                                                                                                                                                                                                                                                                                                            even                                                                                                                                                                                                                                                                                                              unchanged.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        employment                                       calendar                                                                                                           than 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          be subject                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        (full 
                                                                                     a PIN                                                                                                                                                                                                                                                                                                                                                                                   of the                                                                                                                                          and remittances                                                                                                                    but                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              and/or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            received pay for             each                                                                                                                                                                                              have                           and                                                                                                                                                                      State 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              quarter’s                                                                                                                                                                                                                                            whether                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             any 
            payment                                                                                       clients are                                                                                                                                                                                                                                                                                                                                                        end                                                                                                                                                                                                                          will                                                                    a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Section,                                                                                                                                                                                                                                                                                                                                                                    workers                                                                                                                                                                                                                                                                                                                                                                               website                                                                                                                                of                                                                 those                                                                                                                                        the                              vacation                                                                          other 
                                                         taxable wages                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    the 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                quarter,  report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      . For more information,                                                                                                                                                                      report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   workers                                                                                                                                                                                                            covered                                                                           pay,                                                           retirement;                            (c) 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Protested”                                                                                                                                                                                                                                                                                                                                                                                                                                        Line
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           quarterly 
                                                         your                        contain                                                                                                                                                                                                                                                                                                                                                                                 the                                                                                                                                             Reports                                                                      date                                                                    file                contesting                                                                                                                                                                                                                                                                                                                                                                                                                                              current                                                                                                                                                                                                                                                                                                                                                                                              have                                                                                                                                                                                                                                                                                                                                                                                  our                                                                                                                                    12th                                                               and                                                                                                                            who           during                                                                                          of                 paid 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               for                                                                                                                                                                                     and                                                within 
            your                                                                                          your                                                                                                                                                                                                                                                                                                                                       contribution payment                                                                                                                                                                                                                                                                                       a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Hot                                                                                                                                                                                                                         the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   at                                                                                                                                     the                                                                year                                                                                                                                                          commissions 
                                                                                     not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     31.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              the                                                                                                                                                                                                                underreported                                                                                                                                                                     longer                                                                                                                                                                                                                                                                                                                                                                                                                                                                   covered 
                                                                                                                                                                                                                                                                                                                                                                                                                                                     the                                                                                                                                                                                                                                                  that                                                                    must                                               “Liability                                                                                                                                                                                                                                                                                            (UI-3/40)                                                                                                                                                                                                                                                                                                                                                               on 
            make                                                                                          assist                                                                                                                                                                                                                                                                                                                                                             following                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        on                                                                                                                                                                                                                 are                                                                                                                                                                               no                                                                                                                                                                                                                                                                                                                                                                                                                                                                       of                                                                                                                                                                                                                 quarter                            workers                $13,590                 separation                                                     account 
                                                                                     does                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              lodging, 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                during                                employer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  of                                                                                              on 
            and  calculate                                                                                to                                                                                                                                                                                                                                                                                                                                         and                                                                                                                                                                     January                                                                      after                                                                                                                                                                                                                                                                                                                                                                                                                            report                                                                                                                                      Employer                                                                                                                                                                                                                    note                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  obtained                                                                                                                                                                                                                                                                                              the                                to                             salaries,                                                                                         remuneration                                                           performed                                      the Federal Unemployment Tax Act.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   you                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             calendar
                                                                                     form                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             An  write                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  there                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   be                                                                                 number                                                                                                                                                                                                             in                                                                                                                                                                  of                  and                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                             month 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 (a) 
            report  will                                                             this                                                                                                                                                                                                                                                                                                                                                            filed,                                                                                                                                                                  and                                                                                                                                wages             employer,                                                                                                                                                                                                                                                                                                                                                                                                                                                                   quarters                 the                                                                                                                                                                                                                                                                                                                                                                         that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            the                                                                                                                            paid          excess                           employer;                                                                                                                                                                                               under
                                                                                                                                                                                                                                                                                                                                                                                                                                                                             the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           wage                                                                                                                                                                                                                                                                                                                                                                    Please                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 services
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                                                                                                                                                                                                                                                                                                                                                                                                                                                     be                      of                                                                                                                                              31                                                                                                                                 no                an                                                                                                                                                                                                                                                                                                                                                                                                                                                                          prior                    from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 total                  performed services during or                                                                                            paid sick leave. Exclude workers on strike.                         paid                                                                              the                                                            payments           value               meals     
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           or
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        after completing all items and signing the report.                                                                                                                                                                                                 and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      in
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          postmarked                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      for 
                                                                                                          MyTax                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Quarter”.                                                                                                                                                                                                                                                                                                                                                                                                                                               for                      form                                                                                                                                                                                      whenever                                                                                                                                                                          indicate                                                                                                                                                                                                                                                                                                                                                                                                          and should be attached to your report.                 the                    who                                                                                                                                                                                                                                                           include         to                                                             pay,
            quarterly  which                                                         preparer,  Illinois                                                                                                                                                                                                                                                                                                                                             must                    day                                                                                                                                                                                                                          or                                                    paid              being                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            quarter.                                                                                                                                        to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          wages                              wages in                                                                                                                         cash                                                                                                                  wages 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         forms                                                                                                                                  payroll period including
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                wages                                                                                                                                  goods,
                                                         application,                                                                                                                                                                                                                                                                                                                                                                                                        last                                                                                                                                            October                                                                                                                                                                  This                                                                              report                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   filed                             a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Enter                  time)                        the  quarter.  Include  workers  who  have  earned  more  than the         $13,590         vacation                                                            all                                                                                                                                              sick 
            your                                                                                          Illinois                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           31,                                                                                                                                who                                                                                                                     the                                                                                                                                                                                                                                                contribution                                                                                                                                                                                                                                                                                                                                                            for                                                                                                                                             box                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Wages           reported                                                                                              as                                                                                                                                                                  An employer who paid no wages during a quarter, but has not 
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                                                                                                                                                                                                                                                                                                                                                                                                                                                     report                  the                                                                                                                                                                                                                                                                                                  ceased              Paid  contributions  should of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     These                                                                              -
            file                                         Illinois  tax                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    delivered                                                                                                                                                                     on                                                                                                                                                                                                                                                 the                                                                                                                adjustments              the                                                                                                                                                                                                                                                                                                                                                                         this                                                                                                                                                                                                                                                                                                                                                                                   
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Enter                              including     received         year.           tips                                                           prizes,            reasonable          such                                               remuneration                                   considered                                                  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                 noApril                                                                                                                                                         laterpersonally                                                         penalty                        byAn                          thaneachpermanently “NotheemployerWagesthepaymentreasonmust                                                                                                                                                                                                                                                                                                                                                                                                                 Make        subjectRequest                              Division,pleaseshould                                                                                                                             to33thevisitSouthIllinoistheState"Contact-                                                                                                                                                                  Street,UnemploymentIDES"Chicago,pageIllinoisonInsurance60603the IDES website. Reporting errors 
            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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