Form UC-114 "Low Earnings Report" - Delaware

What Is Form UC-114?

This is a legal form that was released by the Delaware Department of Labor - a government authority operating within Delaware. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Delaware Department of Labor;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form UC-114 by clicking the link below or browse more documents and templates provided by the Delaware Department of Labor.

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Download Form UC-114 "Low Earnings Report" - Delaware

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State of Delaware Department of Labor
UC-114
Department of Labor
LOW EARNINGS REPORT
Division of Unemployment Insurance
Social Security Number
Employee’s Name (Please Print)
Local Office
Employee’s Gross
Holiday Pay For Any Date In This
Pay Period Ending On
Holiday Date
Hourly Pay
Pay Period
Please complete below for this pay period.
Total Number
Total Number
Gross Wages
Hours Absent
Dates
Hours Worked
Earned Each Day
Gratuities
Each Day When
Each Day
Work Available
Totals
During the pay period of this report, the above named employee worked reduced hours due to lack of work.
I CERTIFY that the answers and wage information are correct as indicated on this form.
Employer’s Name:
Address:
Address:
City/State/Zip
Phone #
Employer’s Signature:
Date:
*Gross earnings from other employers or from odd jobs during the week of this report. (If
none, write “none”)
Date(s) on which this income was earned:
*Gross earnings are before any deductions or taxes are taken out.
During each day of the pay period of this report, I was able to work and available to work. I am requesting partial
unemployment benefits under the provisions of the State of Delaware’s Unemployment Compensation Law.
I CERTIFY that I have earned no wages other than those reported on this form. I understand that the law provides
penalties for any individual who has made a false statement or representation knowing it to be false or knowingly has
failed to disclose a material fact in order to obtain benefits to which said individual is not lawfully entitled.
Employees Signature:
For Office Use Only:
Street Address:
LO Rep
Street Address:
City/State/Zip Code:
Date
Telephone Number:
State of Delaware Department of Labor
UC-114
Department of Labor
LOW EARNINGS REPORT
Division of Unemployment Insurance
Social Security Number
Employee’s Name (Please Print)
Local Office
Employee’s Gross
Holiday Pay For Any Date In This
Pay Period Ending On
Holiday Date
Hourly Pay
Pay Period
Please complete below for this pay period.
Total Number
Total Number
Gross Wages
Hours Absent
Dates
Hours Worked
Earned Each Day
Gratuities
Each Day When
Each Day
Work Available
Totals
During the pay period of this report, the above named employee worked reduced hours due to lack of work.
I CERTIFY that the answers and wage information are correct as indicated on this form.
Employer’s Name:
Address:
Address:
City/State/Zip
Phone #
Employer’s Signature:
Date:
*Gross earnings from other employers or from odd jobs during the week of this report. (If
none, write “none”)
Date(s) on which this income was earned:
*Gross earnings are before any deductions or taxes are taken out.
During each day of the pay period of this report, I was able to work and available to work. I am requesting partial
unemployment benefits under the provisions of the State of Delaware’s Unemployment Compensation Law.
I CERTIFY that I have earned no wages other than those reported on this form. I understand that the law provides
penalties for any individual who has made a false statement or representation knowing it to be false or knowingly has
failed to disclose a material fact in order to obtain benefits to which said individual is not lawfully entitled.
Employees Signature:
For Office Use Only:
Street Address:
LO Rep
Street Address:
City/State/Zip Code:
Date
Telephone Number: