Form UI-5 "Quarterly Wage Report" - Montana

What Is Form UI-5?

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 January 1, 2020;
  • 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-5 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-5 "Quarterly Wage Report" - Montana

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Quarter End
Due Date
Montana Employer’s Unemployment Insurance (UI)
Quarterly Wage Report – Form UI-5
Employer Identification Numbers
UI Account Number
Federal Id (FEIN)
UI Contribution Rate
UI Administrative Fund Tax Rate
UI Total Tax Rate
UI Annual Taxable Wage Base
(Each Employee)
$34,100.00
A report must be filed even if no wages are paid. Instructions for completing this form are
online at
http://uid.dli.mt.gov/forms
or call 406-444-3834. File online at
UIeServices.mt.gov
. If paying by check, please use attached voucher.
Step 1.
No Wages paid for the quarter covering this report
Check
Sold Business – Name, address and phone number of new owner:
applicable boxes
Ceased Employing – Last payroll date
/
/
and provide
Change in Name, Address, Phone Number or Federal ID # (list corrections here):
information
Amended Report. Please attach an explanation and include the name(s) of any employees changed.
requested:
Step 2. Unemployment Insurance Employee Wage Listing
Check here if wage listing is attached.
Name of Employee
Employee’s Social
Total Wages
Excess Wages
Security Number
Last Name
First Name
Paid this Quarter
This Quarter
Totals
Step 4. Number of
State Unemployment
Step 3. Calculate Tax
Insurance Tax
UI Employees
1. Total wages paid this quarter
>
Number of covered
>
2. UI excess wages (Except Governmental and Reimbursable Accts.)
workers who worked
during, or received pay for,
3. UI taxable wages (line 1 minus line 2)
>
the payroll period that
4. UI total tax rate
includes the 12
day of
th
5. Total tax (multiply line 3 times line 4)
the month:
6. Credits (overpayment from prior quarters)
1
month
st
7. Adjustments to prior quarters (attach explanation)
2
month
_
nd
8. Balance due (line 5 – line 6 +/- line 7 -- see instructions)
9. If filing late, add penalty ($25) and interest (line 8 x 1.5% x month(s) past due)
3
month
rd
>
10. Payment enclosed (line 8 +9)
Make Check Payable to Unemployment Insurance Division
Step 5. Signature.
Sign and make a copy of this form for your records. Mail your report, additional wage listings and payment by the due date
above, even if no wages are paid or tax is due. Questions? Call (406) 444-3834.
Mail to:
I certify the information on this report is true and correct.
Date:
Unemployment Insurance
Contributions Bureau
Authorized Signature
Telephone Number
Name of Contact Person
Telephone No
PO Box 6339
Helena MT 59604-6339
Mail this form with your check to the Unemployment Insurance Contributions Bureau
UI-5 Revised 1/20
Quarter End
Due Date
Montana Employer’s Unemployment Insurance (UI)
Quarterly Wage Report – Form UI-5
Employer Identification Numbers
UI Account Number
Federal Id (FEIN)
UI Contribution Rate
UI Administrative Fund Tax Rate
UI Total Tax Rate
UI Annual Taxable Wage Base
(Each Employee)
$34,100.00
A report must be filed even if no wages are paid. Instructions for completing this form are
online at
http://uid.dli.mt.gov/forms
or call 406-444-3834. File online at
UIeServices.mt.gov
. If paying by check, please use attached voucher.
Step 1.
No Wages paid for the quarter covering this report
Check
Sold Business – Name, address and phone number of new owner:
applicable boxes
Ceased Employing – Last payroll date
/
/
and provide
Change in Name, Address, Phone Number or Federal ID # (list corrections here):
information
Amended Report. Please attach an explanation and include the name(s) of any employees changed.
requested:
Step 2. Unemployment Insurance Employee Wage Listing
Check here if wage listing is attached.
Name of Employee
Employee’s Social
Total Wages
Excess Wages
Security Number
Last Name
First Name
Paid this Quarter
This Quarter
Totals
Step 4. Number of
State Unemployment
Step 3. Calculate Tax
Insurance Tax
UI Employees
1. Total wages paid this quarter
>
Number of covered
>
2. UI excess wages (Except Governmental and Reimbursable Accts.)
workers who worked
during, or received pay for,
3. UI taxable wages (line 1 minus line 2)
>
the payroll period that
4. UI total tax rate
includes the 12
day of
th
5. Total tax (multiply line 3 times line 4)
the month:
6. Credits (overpayment from prior quarters)
1
month
st
7. Adjustments to prior quarters (attach explanation)
2
month
_
nd
8. Balance due (line 5 – line 6 +/- line 7 -- see instructions)
9. If filing late, add penalty ($25) and interest (line 8 x 1.5% x month(s) past due)
3
month
rd
>
10. Payment enclosed (line 8 +9)
Make Check Payable to Unemployment Insurance Division
Step 5. Signature.
Sign and make a copy of this form for your records. Mail your report, additional wage listings and payment by the due date
above, even if no wages are paid or tax is due. Questions? Call (406) 444-3834.
Mail to:
I certify the information on this report is true and correct.
Date:
Unemployment Insurance
Contributions Bureau
Authorized Signature
Telephone Number
Name of Contact Person
Telephone No
PO Box 6339
Helena MT 59604-6339
Mail this form with your check to the Unemployment Insurance Contributions Bureau
UI-5 Revised 1/20