Form UI-5A "Montana Unemployment Insurance Employee Wage Listing" - Montana

What Is Form UI-5A?

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

Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Montana Department of Labor and Industry;
  • 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 UI-5A by clicking the link below or browse more documents and templates provided by the Montana Department of Labor and Industry.

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Download Form UI-5A "Montana Unemployment Insurance Employee Wage Listing" - Montana

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MONTANA UNEMPLOYMENT INSURANCE
EMPLOYEE WAGE LISTING - Form UI-5A
Use this form (or a facsimile) as a continuation sheet for the UI employee wage listing on the Montana Employer's Unemployment Insurance
Quarterly Wage Report - Form UI-5 (Step 2).
Employer's Name and Address:
UI Account No:
FEIN:
Quarter End:
Name of Employee
Employee’s Social
Total Wages Paid
Excess Wages
this Quarter
This Quarter
Security Number
Last Name
First Name
Totals
Page No._______ of _________
For additional UI Employee Wage Listing Forms UI5A, please photocopy a blank form or call 406-444-3834. Attach the completed
UI5A to the UI Quarterly Wage Report and mail to the Unemployment Insurance Contributions Bureau PO Box 6339, Helena, MT 59604-6339
FORM UI5A Rev. 03/18
MONTANA UNEMPLOYMENT INSURANCE
EMPLOYEE WAGE LISTING - Form UI-5A
Use this form (or a facsimile) as a continuation sheet for the UI employee wage listing on the Montana Employer's Unemployment Insurance
Quarterly Wage Report - Form UI-5 (Step 2).
Employer's Name and Address:
UI Account No:
FEIN:
Quarter End:
Name of Employee
Employee’s Social
Total Wages Paid
Excess Wages
this Quarter
This Quarter
Security Number
Last Name
First Name
Totals
Page No._______ of _________
For additional UI Employee Wage Listing Forms UI5A, please photocopy a blank form or call 406-444-3834. Attach the completed
UI5A to the UI Quarterly Wage Report and mail to the Unemployment Insurance Contributions Bureau PO Box 6339, Helena, MT 59604-6339
FORM UI5A Rev. 03/18