New York State Website

UI Forms and Publications

To print these forms, you need an installed copy of Adobe Acrobat Reader version 4.0 or higher, which is available at no charge from Adobe.

Some of the applications listed on this page ask for certain personal information. The authority to collect this information is found in the New York State Labor Law. This information will be maintained and used to process the application you are filing with the Department. If you do not provide the information, the Department may not be able to process your application.

You may review any information about you that is maintained by the New York State Department of Labor by contacting our Counsels Office at 518 485 4380.


Reporting Forms

Form Description/Purpose Size Type
IA 7 -- Annual Supplementary Contribution Report Use this form to report wages not previously reported as remuneration for the 2008 calendar year, if your tax rate is 5.4% or lower. 1 page pdf
IA 7 A -- Annual Supplementary Contribution Report Use this form to report wages not previously reported as remuneration for the 2008 calendar year, if your tax rate is 5.5% or higher. 1 page pdf
NYS-45 -- Quarterly Combined Withholding, Wage Reporting and Unemployment Insurance Return

Use this form to report Unemployment Insurance and withholding tax. Please note: the extention of -MN after the form number refers to a manual version of the form. For instructions,click here.

2 pages pdf
NYS-45-ATT -- Quarterly Combined Withholding, Wage Reporting and Unemployment Insurance Return - Attachment

Use this form to report Unemployment Insurance and withholding tax. Please note: the extention of -MN after the form number refers to a manual version of the form. For instructions,click here.

1 page pdf
NYS-45X -- Amended Quarterly Return Use this form to correct previously reported unemployment insurance, withholding tax and/or wage reporting information.For instructions, Click Here 2 pages pdf
IA 198 P -- Protest Document for Failure to File Penalties

Use this form to protest a failure to file penalty.

1 page pdf
IA 318.26 -- Joint Enforcement Task Force on Employee Misclassification, Reporting Fraud and Other Violations

Use this form if you believe an employer is committing fraud by misclassifying its workers or committing other violations.

2 pages pdf

Registration Forms

Form Description/Purpose Size Type
IA 12.3 -- Record of Employment Give this completed form to separated employees to facilitate their application for UI benefits. 1 page pdf
IA 15 -- Change of Business Information Use this form to provide us with changes to your existing business information, such as a discontinuance of your business, a change in ownership or type, or a change of address. 2 pages pdf
IA 16 -- Important Information about Unemployment Insurance Use this form if you are registered with the NYS Tax Department for withholding and wage reporting purposes and have not registered for NYS Department of Labor's Unemployment Insurance program. 1 page pdf
NYS-100 -- Employer Registration Form for Unemployment Insurance, Withholding and Wage Reporting

Complete this form if you are a business employer or a household employer of domestic services , to register for unemployment insurance, withholding tax and wage reporting.

To register online - click here.

4 pages pdf
NYS-100G -- Employer Registration Form for Unemployment Insurance, Withholding and Wage Reporting for Governmental Entities. Completed by governmental employers to register for unemployment insurance, withholding tax and wage reporting. 2 pages pdf
NYS-100A -- Employer Registration Form for Unemployment Insurance, Withholding and Wage Reporting for Agricultural Employers Complete this form if you are an agricultural employer to register for unemployment insurance, withholding tax and wage reporting. 4 pages pdf
NYS-100N -- Registration Form for Non-Profit Employers Complete this form if you are a non-profit employer to register for unemployment insurance, withholding tax and wage reporting. 4 pages pdf
NYS-100IT -- Employer Registration Form for Unemployment Insurance, Withholding and Wage Reporting for Indian Tribes Complete this form if you are an Indian Tribe , subdivision, subsidiary, or business enterprise wholly owned by such Indian Tribe to register for unemployment insurance, withholding tax and wage reporting. 2 pages pdf

Shared Work Forms

Form Description/Purpose Size Type
SW 2.1 -- Shared Work Application Use this form to apply for the Shared Work Plan. 3 pages pdf
SW 2.2 -- Shared Work Plan Participant Listing Use this form to list employees participating in the Shared Work Plan. 3 pages pdf
SW 4 -- Shared Work Continued Claim Use this bi-weekly certification form to confirm the status of employees on your Shared Work Plan. 2 pages pdf
SW 4.1 -- Shared Work Continued Claim Waiting Week Certification

Give this form to employees to claim first reduced week in Shared Work Plan Benefits

2 pages pdf
SW 330 -- Application for Benefits, Shared Work Plan Give this form to employees to claim Shared Work Plan Benefits. 1 page pdf
SW 330.2 -- Continuation of Employment record This form is a continuation of the Application for Benefits, Shared Work Plan (SW330). Give to employees with more than one employer in the last 18 months, to claim Shared Work Plan Benefits. 1 page pdf

Claimant Forms

Form Description/Purpose Size Type
IA 1099.1 -- Request for Income Tax Witholding Report (1099G) Use this form to request a statement of tax withholding from Unemployment Insurance Benefits received. 1 page pdf
T402 Albanian -- Modele të Përcaktimit të Përfitimit Monetar (T402B nëse kualifikoheni) (T402N nëse nuk kualifikoheni)

 

قسيمة البريد الموثق

 

إذا كنت مؤهلاً) (T402N  إذا لم تكن مؤهلاً)

 

2 pages pdf
T402 Arabic -- قسيمة البريد الموثق

 

قسيمة البريد الموثق

 

استمارات ت حديد الإعانات المالية (T402B  إذا كنت مؤهلاً) (T402N  إذا لم تكن مؤهلاً)

 

 

2 pages pdf
T402 Bengali -- আর্থিক সুবিধা নির্ধারণীর টেমম্লেট(উপযুক্ত বিবেচিত হলে টি ৪০২ বি) তবে (উপযুক্ত বিবেচিত না হলে টি ৪০২ এন)

আর্থিক সুবিধা নির্ধারণীর  টেমম্লেট(উপযুক্ত বিবেচিত হলে টি ৪০২ বি) তবে (উপযুক্ত বিবেচিত  না হলে টি ৪০২ এন)

2 pages pdf
T402 Chinese -- 證明券 貨幣保險金裁決範本(合格請用T402B)(不合格請用T402N) 直接付款卡資訊

證明券 

貨幣保險金裁決範本(合格請用T402B)(不合格請用T402N     

直接付款卡資訊

     

 

 

2 pages pdf
T402 French -- Modèles de Détermination des allocations financières (T402B en cas d’éligibilité) (T402N en cas de non éligibilité)

Modèles de Détermination des allocations financières (T402B en cas d’éligibilité) (T402N en cas de non éligibilité)   

2 pages pdf
T402 Haitian-Creole -- Fòmil Detèminasyon Alokasyon Finansyè (T402B si kalifye) (T402N si pa kalifye)

Fòmil Detèminasyon Alokasyon Finansyè (T402B si kalifye) (T402N si pa kalifye)     

2 pages pdf
T402 Italian -- Modelli per la Determinazione dell’importo del sussidio (Monetary Amount Determination) (T402B se si qualifica) (T402N se non si qualifica)

Modelli per la Determinazione dell’importo del sussidio (Monetary Amount Determination) (T402B se si qualifica) (T402N se non si qualifica)   

2 pages pdf
T402 Korean -- 금전적 수혜금 결정(Monetary Benefit Determination) 안내서 (자격 시 T402B) (결격 시 T402N)

금전적 수혜금 결정(Monetary Benefit Determination) 안내서 (자격 T402B) (결격 T402N)   

2 pages pdf
T402 Polish -- Przykłady Oszacowania Finansowego Świadczeń (T402B jeżeli się kwalifikujesz) (T402N jeżeli się nie kwalifikujesz)

Przykłady Oszacowania Finansowego Świadczeń (T402B jeżeli się kwalifikujesz) (T402N jeżeli się nie kwalifikujesz)   

2 pages pdf
T402 Russian -- Шаблоны для определения суммы денежного пособия (T402B при соответствии требованиям) (T402N при несоответствии)

Шаблоны для определения суммы денежного пособия (T402B при соответствии требованиям) (T402N при несоответствии)     

2 pages pdf
TC 343 EB -- Extended Benefits Monthly Work Search Record - English

Use this form to list all of the employers and unions you contact each week while claiming extended benefits.

1 page pdf
TC 343 EB -- Extended Benefits Monthly Work Search Record - Spanish

Use this form to list all of the employers and unions you contact each week while claiming extended benefits.

1 page pdf
TC403HA -- Request for Alternate Base Period Use this form to request that your weekly benefit rate be calculated based on your alternate quarter wages. 1 page pdf
TC403HA Albanian -- Kërkesa për Rikonsiderim

Kërkesa për Rikonsiderim

1 page pdf
TC403HA Arabic -- طلبات التماسات فترة أساسية بديلة

طلبات التماسات فترة أساسية بديلة

1 page pdf
TC403HA Bengali -- বিকল্প বেইস সময়ের জন্য অনুরোধ(টিসি ৪০৩ এইচএ)

বিকল্প বেইস সময়ের জন্য অনুরোধ(টিসি ৪০৩ এইচএ)

1 page pdf
TC 403HA Chinese -- 替代基準期申請表

替代基準期申請表

1 page pdf
TC 403 HA Haitian-Creole -- Demann pou yon Peryòd de Baz Altènatif

Demann pou yon Peryòd de Baz Altènatif

1 page pdf
TC 403HA French -- Demande de période de base alternative

Demande de période de base alternative

1 page pdf
TC 403HA Italian -- Richiesta di un periodo base alternativo

Richiesta di un periodo base alternativo

1 page pdf
TC 403HA Korean -- 대체 기준 기간 요청서

대체 기준 기간 요청서

1 page pdf
TC 403HA Polish -- Wniosek o alternatywny okres bazowy

Wniosek o alternatywny okres bazowy

1 page pdf
TC 403HA Russian -- Просьба назначить другой базовый период

Просьба назначить другой базовый период

1 page pdf
TC503HAS -- SEGURO POR DESEMPLEO - Solicitud Para Período Alterno SEGURO POR DESEMPLEO - Solicitud Para Período Alterno 1 page pdf
TC 403HR -- Request for Reconsideration Use this form to correct and/or add wages not reflected on your Monetary Benefit Determination. 1 page pdf
TC 403HR Albanian -- Kërkesa për Rikonsiderim (TC403HR)

Kërkesa për Rikonsiderim (TC403HR)

1 page pdf
TC 403HR Arabic -- طلبات إعادة النظر

طلبات إعادة النظر

1 page pdf
TC 403HR Bengali -- পুনর্বিবেচনার জন্য অনুরোধ

পুনর্বিবেচনার জন্য অনুরোধ

1 page pdf
TC 403HR Chinese -- 重新審議申請表

新審議申請表

1 page pdf
TC 403HR French -- Demande de reconsidération

Demande de reconsidération

1 page pdf
TC 403HR Haitian-Creole -- Demann pou Rekonsiderasyon

Demann pou Rekonsiderasyon

1 page pdf
TC 403HR Italian -- Richiesta di revisione

Richiesta di revisione

1 page pdf
TC 403HR Korean -- 재고 요청서

재고 요청서

1 page pdf
TC 403HR Polish -- Wniosek o ponowne rozpatrzenie

Wniosek o ponowne rozpatrzenie

1 page pdf
TC 403HR Russian -- Просьба о пересмотре

Просьба о пересмотре

1 page pdf
S403HRS -- SEGURO POR DESEMPLEO - Solicitud Para Reconsideración SEGURO POR DESEMPLEO - Solicitud Para Reconsideración 1 page pdf
TCC 406L Albanian -- Kupon i certifikimit me postë

Kupon i certifikimit me postë

3 pages pdf
TCC 406L Arabic -- قسيمة البريد الموثق

قسيمة البريد الموثق

3 pages pdf
TCC 406L Bengali -- ডাকযোগে প্রেরীত কূপন সত্যায়ন

ডাকযোগে প্রেরীত কূপন সত্যায়ন

3 pages pdf
TCC 406L Chinese -- 直接付款卡資訊

直接付款卡資訊

3 pages pdf
LO403.5 -- Request for Rate Based on Weeks of Employment Use this form to request a weekly benefit rate based your average weekly wage. 1 page pdf
LO 403.5 Albanian -- Kërkesa për Kursin bazuar në Javët e Punësimit

Kërkesa për Kursin bazuar në Javët e Punësimit

1 page pdf
LO 403.5 Arabic -- طلبات الأجر بناءً على الأعمال الأسبوعية

طلبات الأجر بناءً على الأعمال الأسبوعية

1 page pdf
LO 403.5 Bengali -- চাকুরিকালীন সপ্তাহের ভিত্তিতে হার নির্ধারণের জন্য অনুরোধ(এলও ৪০৩.৫ )

চাকুরিকালীন সপ্তাহের ভিত্তিতে হার নির্ধারণের জন্য অনুরোধ(এলও ৪০৩.৫ )

1 page pdf
LO 403.5 Chinese -- 基於就業週數的費率申請表

基於就業週數的費率申請表

1 page pdf
LO 403.5 French -- Demande de montant d’allocations basé sur les semaines de travail

Demande de montant d’allocations basé sur les semaines de travail

1 page pdf
LO 403.5 Haitian-Creole -- Demann pou Montan Baze sou Semèn Travay

Demann pou Montan Baze sou Semèn Travay

1 page pdf
LO 403.5 Italian -- Richiesta per sussidio basato sulle settimane di lavoro

Richiesta per sussidio basato sulle settimane di lavoro

1 page pdf
LO 403.5 Korean -- 주에 근거한 지급액 요청서

주에 근거한 지급액 요청서

1 page pdf
LO 403.5 Polish -- Podanie o przyznanie stopy świadczeń w oparciu o tygodnie zatrudnienia

Podanie o przyznanie stopy świadczeń w oparciu o tygodnie zatrudnienia

1 page pdf
LO 403.5 Russian -- Просьба о назначении ставки на основе количества недель без работы

Просьба о назначении ставки на основе количества недель без работы

1 page pdf
LO 403.5S -- Petición para la Tasa Basada en las Semanas de Trabajo Petición para la Tasa Basada en las Semanas de Trabajo 4 pages pdf

Publications

Form Description/Purpose Size Type
IA 98 This is a Notice of Unemployment Insurance Tax Rates intended for new employers. 1 page pdf
IA 116.3 Determining Jurisdiction of Employment when services are performed in a number of states 2 pages pdf
IA 318.2 Unemployment Insurance Benefits, An Employer's Guide 8 pages pdf
IA 318.10 The Relationship of NYS and Federal UI Tax Reporting For 2005, New York is a credit reduction state and therefore the FUTA credit is 4.8%. For additional information, please click here. 2 pages pdf
IA 318.11 Agricultural Employment 2 pages pdf
IA 318.12 Experience Rating 8 pages pdf
IA 318.13 Benefit Reimbursement 2 pages pdf
IA 318.14 Independent Contractors 2 pages pdf
IA 318.15 Reporting Meals, Lodging, Tips and Other Forms of Remuneration 2 pages pdf
IA 318.16 Organized Camps 1 page pdf
IA 318.17 Performing Artists 7 pages pdf
IA 318.18 Insurance Sales Industry 6 pages pdf
IA 318.19 Newspaper and Shopping Guide Publishing Industry 4 pages pdf
IA 318.20 Translating and Interpreting Industry 7 pages pdf
IA 318.21 Tour Guide Industry 4 pages pdf
IA 318.22 Van Operators In The Moving Industry 4 pages pdf
IA 318.23 Magazine Publishing Industry 4 pages pdf
IA 318.24

Messenger Courier Industry

12 pages pdf
IA 318.60 Tips for Keeping Costs Down For 2005, New York is a credit reduction state and therefore the FUTA credit is 4.8%. For additional information, please click here . 4 pages pdf
IA 318.D Householder's Guide for Unemployment Insurance 4 pages pdf
IA 318.IS.1 Important Notice to Employers Regarding the Interest Assessment Surcharge 1 page pdf
IA 318 IT Indian Tribes 3 pages pdf
LO 318.7 UI benefits while you are in training. 2 pages pdf
LO 424A Hearings Before Unemployment Insurance Administrative Law Judges. 2 pages pdf
LO 424B Questions and Answers About Your Unemployment Insurance Benefits Hearing. 2 pages pdf
LO 424.4 -- List of Attorneys and Authorized Agents

A list of legal services organizations that provide free legal services in unemployment hearings for persons found financially eligible.

2 pages pdf
LO 424.4S -- Spanish- List of Attorneys and Authorized Agents Spanish version of the LO 424.4 above. 2 pages pdf
NYS-50 -- Employer's Guide to Unemployment Insurance, Wage Reporting and Withholding Tax

This complete guide for employers tells how to comply with Unemployment Insurance tax, Wage Reporting and Withholding tax obligations.

48 pages pdf
OC 923

This document provides information for New York State employers about Workers Compensation coverage.

2 pages pdf
P160 -- How to file a claim for Unemployment Insurance

This brochure explains how to file a new Unemployment Insurance Claim.

2 pages pdf
P160AL -- How to file a claim for Unemployment Insurance - Albanian

This is the Albanian language version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P160AR -- How to file a claim for Unemployment Insurance - Arabic

This is the Arabic language version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P160TC -- How to file a claim for Unemployment Insurance - Traditional Chinese

This is the Traditional Chinese language version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P160B -- How to file a claim for Unemployment Insurance - Bengali

This is the Bengali language version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P160F -- How to file a claim for Unemployment Insurance - French

This is the French language version of the brochure on how to file an Unemployment Insurance Claim.

2 pages pdf
P160HC -- How to file a claim for Unemployment Insurance - Haitian Creole

This is the Haitian Creole language version of the brochure on how to file an Unemployment Insurance Claim.

2 pages pdf
P160I -- How to file a claim for Unemployment Insurance - Italian

This is the Italian language version of the brochure on how to file an Unemployment Insurance Claim.

2 pages pdf
P160K -- How to file a claim for Unemployment Insurance - Korean

This is the Korean language  version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P160P -- How to file a claim for Unemployment Insurance - Polish

This is the Polish language  version of the brochure on how to file a new Unemployment Insurance Claim.

2 pages pdf
P 160S -- How to file a claim for Unemployment Insurance - Spanish

This is the Spanish language version of the brochure on how to file an Unemployment Insurance Claim.

2 pages pdf
P 160R -- How to file a claim for Unemployment Insurance - Russian

This is the Russian language version of the brochure on how to file an Unemployment Insurance Claim.

2 pages pdf
P 806 -- COBRA Subsidy Information for Employers

Fact Sheet

1 page pdf
TC 318.3 -- Unemployment Insurance Information for Claimants

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.    

31 pages pdf
TC 318.3-Albanian -- Unemployment Insurance Information for Claimants (Albanian)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.   

2 pages pdf
TC 318.3-Arabic -- Unemployment Insurance Information for Claimants(Arabic)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.   

63 pages pdf
TC 318.3-Bengali -- Unemployment Insurance Information for Claimants (Bengali)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.    

2 pages pdf
TC 318.3-Chinese -- Unemployment Insurance Information for Claimants (Chinese)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.   

63 pages pdf
TC 318.3-French -- Unemployment Insurance Information for Claimants (French)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.   

63 pages pdf
TC 318.3-Italian -- Unemployment Insurance Information for Claimants (Italian)

A handbook that provides general information on eligibility for Unemployment Insurance benefits in New York State.

63 pages pdf
TC 318.3-Russian -- Unemployment Insurance Information for Claimants (Russian)

A handbook written in Russian that provides general information on eligibility for Unemployment Insurance benefits in New York State.

64 pages pdf
TC 318.3-Haitian Creole -- Unemployment Insurance Information for Claimants (Haitian Creole) A handbook written in Haitian Creole that provides general information on eligibility for Unemployment Insurance benefits in New York State.

64 pages pdf
TC 318.3-Polish -- Unemployment Insurance Information for Claimants (Polish) A handbook written in Polish that provides general information on eligibility for Unemployment Insurance benefits in New York State. 64 pages pdf
TC 318.3-Korean -- Unemployment Insurance Information for Claimants (Korean) A handbook written in Korean that provides general information on eligibility for Unemployment Insurance benefits in New York State. 63 pages pdf
TC 318.4 -- Unemployment Insurance Information for Claimants (Spanish)

A handbook written in Spanish that provides general information on eligibility for Unemployment Insurance benefits in New York State.

33 pages pdf