Sample Form UC-BP-52(A) "Weekly Report of Low Earnings" - Hawaii

What Is Form UC-BP-52(A)?

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

Form Details:

  • Released on July 29, 2014;
  • The latest edition provided by the Hawaii Department of Labor & Industrial Relations;
  • 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 printable version of Form UC-BP-52(A) by clicking the link below or browse more documents and templates provided by the Hawaii Department of Labor & Industrial Relations.

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Download Sample Form UC-BP-52(A) "Weekly Report of Low Earnings" - Hawaii

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UC-BP-161(a)
Revised 07/29/14
INSTRUCTIONS FOR PARTIAL AND PART-TOTAL CLAIMANT’S
FILING THROUGH THE WEB
PARTIAL AND PART-TOTAL CLAIMANTS MUST HAVE THEIR EMPLOYER(S) FILE “WEEKLY
REPORT OF LOW EARNINGS” ONLINE FOR EACH WEEK CLAIMED.
Weekly Report of Low Earnings: In addition to filing your weekly or biweekly claim certification, your
employer must file “Weekly Report of Low Earnings” to verify your earnings, availability for work and
continued employment for each week that you claim.
Form UC-BP-52(a), “Weekly Report of Low Earnings” (shown below) was previously used to report earnings
and eligibility information and process payment. Effective February 26, 2014, the UI Division launched the
“Employer Low Earnings Reporting and Monitoring” system for employers to report the weekly earnings and
eligibility information online. As such, form UC-BP-52(a) will no longer be provided after you file an initial or
additional claim application for benefits.
Please advise your employer go online to:
uiclaims.hawaii.gov
to register and file your weekly report of low
earnings online. The system is available Monday through Friday from 6:30 a.m. to 5:30 p.m. and on weekends
and holidays from 9:00 a.m. to 5:30 p.m. Filing online is faster as it updates your benefit records as soon as the
information is submitted by the employer.
If you or your employer has questions regarding online filing, please call your local claims office during
business hours. For a listing of the various local claims offices and hours of operations, visit our website at:
labor.hawaii.gov/ui/contact/
UC-BP-52(a)
WEEKLY REPORT OF LOW EARNINGS
MO
DAY
YR
MO
DAY
YR
TO
I, ______Your name_________________________________________ am claiming benefits for the week beginning:
(Sunday)
(Saturday)
Claimant name (Last, First Middle)
TO EMPLOYER (See reverse of this form for instructions.)
Before you submit this to your employer, please WRITE in the SUNDAY
to SATURDAY dates for the same week you are filing for.
1.
In the 7 day period indicated above:
a.
Rate of pay ____________
Total Hours Worked _______________
Gross wages earned. __________________________________________
b.
Did the individual accept all work offered?
Yes
No
If no, date did not accept all work _______________________________
Reason all work was not accepted ______________________________________________________________________________________________________
Sample Only – File
2.
What was the last day worked prior to the week for which benefits are being claimed?
MO
DAY
YR
information online
Reason for nonwork:
NO WORK
QUIT
DISCHARGE
OTHER
Explain ______________________________
_____________________________________________________________________________________________________________________________________
MO
DAY
YR
3.
Was the individual TERMINATED? If so, what was the LAST DAY OF WORK?
Reason for separation ?
NO WORK
QUIT
DISCHARGE
OTHER
Explain
I CERTIFY THAT THE INFORMATION IS CORRECT
____________________________________________________
_____________________
__________________________________
______________
Employer/Representative
Telephone No.
Title
Date
UC-BP-161(a)
Revised 07/29/14
INSTRUCTIONS FOR PARTIAL AND PART-TOTAL CLAIMANT’S
FILING THROUGH THE WEB
PARTIAL AND PART-TOTAL CLAIMANTS MUST HAVE THEIR EMPLOYER(S) FILE “WEEKLY
REPORT OF LOW EARNINGS” ONLINE FOR EACH WEEK CLAIMED.
Weekly Report of Low Earnings: In addition to filing your weekly or biweekly claim certification, your
employer must file “Weekly Report of Low Earnings” to verify your earnings, availability for work and
continued employment for each week that you claim.
Form UC-BP-52(a), “Weekly Report of Low Earnings” (shown below) was previously used to report earnings
and eligibility information and process payment. Effective February 26, 2014, the UI Division launched the
“Employer Low Earnings Reporting and Monitoring” system for employers to report the weekly earnings and
eligibility information online. As such, form UC-BP-52(a) will no longer be provided after you file an initial or
additional claim application for benefits.
Please advise your employer go online to:
uiclaims.hawaii.gov
to register and file your weekly report of low
earnings online. The system is available Monday through Friday from 6:30 a.m. to 5:30 p.m. and on weekends
and holidays from 9:00 a.m. to 5:30 p.m. Filing online is faster as it updates your benefit records as soon as the
information is submitted by the employer.
If you or your employer has questions regarding online filing, please call your local claims office during
business hours. For a listing of the various local claims offices and hours of operations, visit our website at:
labor.hawaii.gov/ui/contact/
UC-BP-52(a)
WEEKLY REPORT OF LOW EARNINGS
MO
DAY
YR
MO
DAY
YR
TO
I, ______Your name_________________________________________ am claiming benefits for the week beginning:
(Sunday)
(Saturday)
Claimant name (Last, First Middle)
TO EMPLOYER (See reverse of this form for instructions.)
Before you submit this to your employer, please WRITE in the SUNDAY
to SATURDAY dates for the same week you are filing for.
1.
In the 7 day period indicated above:
a.
Rate of pay ____________
Total Hours Worked _______________
Gross wages earned. __________________________________________
b.
Did the individual accept all work offered?
Yes
No
If no, date did not accept all work _______________________________
Reason all work was not accepted ______________________________________________________________________________________________________
Sample Only – File
2.
What was the last day worked prior to the week for which benefits are being claimed?
MO
DAY
YR
information online
Reason for nonwork:
NO WORK
QUIT
DISCHARGE
OTHER
Explain ______________________________
_____________________________________________________________________________________________________________________________________
MO
DAY
YR
3.
Was the individual TERMINATED? If so, what was the LAST DAY OF WORK?
Reason for separation ?
NO WORK
QUIT
DISCHARGE
OTHER
Explain
I CERTIFY THAT THE INFORMATION IS CORRECT
____________________________________________________
_____________________
__________________________________
______________
Employer/Representative
Telephone No.
Title
Date