Form 1g "School and Government Status Report" - Utah

What Is Form 1g?

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

Form Details:

  • Released on May 1, 2001;
  • The latest edition provided by the Utah Department of Workforce Services;
  • 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 1g by clicking the link below or browse more documents and templates provided by the Utah Department of Workforce Services.

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Download Form 1g "School and Government Status Report" - Utah

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Utah Department of Workforce Services
DWS-U1
Form 1G
Unemployment Insurance
Rev. 5/01
140 East 300 South
P.O. Box 45288
Salt Lake City, Utah 84145-0288
TEL (801) 526-9400
FAX (801) 526-9377
SCHOOL AND GOVERNMENT
STATUS REPORT
INSTRUCTIONS ON REVERSE SIDE. PLEASE COMPLETE ALL ITEMS.
1. Type of Organization:
School District
City Government
County Government
State Government
Other, Specify __________________________
2. Name of School or Governmental Unit:
3. Name and SSN of Each Organization Officer:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
4. Address of School or Governmental Unit Headquarters
5. Mailing Address for Quarterly Contribution (tax) reports if
(No. Street, City, State, Zip Code):
different from item 4: (See Instructions)
Telephone #: (
)
Fax #: (
)
Telephone #: (
)
Fax #: (
)
6. Mailing address for Wage and Separation requests if different
7. Street address of Principal Permanent Work Site in Utah if
from item 5: (See Instructions)
different from item 5: (See Instructions)
Telephone #: (
)
Fax #: (
)
Telephone #: (
)
Fax #: (
)
8. Number of permanent worksites
9. County in Utah where
10. Date organization
11. Federal Employer I.D. Number (FEIN):
in Utah:
principal activity is
in item 2 began
located?
operation:
12. Describe your organization’s principal activity:
13. Elected method of reporting and payment: Important - this decision must be made by individual(s) with the authority to make a financial
commitment for the organization. (See Instructions)
a. Reimbursement of Unemployment Benefits Paid
The above organization elects to reimburse the Unemployment Insurance Fund an amount equal to the amount of regular benefits and of one-
half of the extended benefits paid that is attributable to service performed by former employees of the above organization. This election
requires the filing of quarterly employment and wage reports.
b. Payment of Quarterly Contributions
The above organization elects to file quarterly reports and pay any contributions as required by Section 35A-4-302 of the Utah Employment
Security Act. The following information is needed to determine the tax rate.
14. Enter below the amount of wages you have paid in Utah. If you have not paid wages enter “NONE”.
Jan. 1 to Mar. 31
Apr. 1 to Jun. 30
Jul. 1 to Sep. 30
Oct. 1 to Dec. 31
Current
Year:
Preceding
Year:
15. If you have not paid wages, do you expect to pay wages in the future?
Yes
No Estimated date ___________________________
I certify that I have authority to act as agent for the above organization. The information contained in this report is true and correct.
(
)
Authorized Agent
Title
Telephone
Date
Utah Department of Workforce Services
DWS-U1
Form 1G
Unemployment Insurance
Rev. 5/01
140 East 300 South
P.O. Box 45288
Salt Lake City, Utah 84145-0288
TEL (801) 526-9400
FAX (801) 526-9377
SCHOOL AND GOVERNMENT
STATUS REPORT
INSTRUCTIONS ON REVERSE SIDE. PLEASE COMPLETE ALL ITEMS.
1. Type of Organization:
School District
City Government
County Government
State Government
Other, Specify __________________________
2. Name of School or Governmental Unit:
3. Name and SSN of Each Organization Officer:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
4. Address of School or Governmental Unit Headquarters
5. Mailing Address for Quarterly Contribution (tax) reports if
(No. Street, City, State, Zip Code):
different from item 4: (See Instructions)
Telephone #: (
)
Fax #: (
)
Telephone #: (
)
Fax #: (
)
6. Mailing address for Wage and Separation requests if different
7. Street address of Principal Permanent Work Site in Utah if
from item 5: (See Instructions)
different from item 5: (See Instructions)
Telephone #: (
)
Fax #: (
)
Telephone #: (
)
Fax #: (
)
8. Number of permanent worksites
9. County in Utah where
10. Date organization
11. Federal Employer I.D. Number (FEIN):
in Utah:
principal activity is
in item 2 began
located?
operation:
12. Describe your organization’s principal activity:
13. Elected method of reporting and payment: Important - this decision must be made by individual(s) with the authority to make a financial
commitment for the organization. (See Instructions)
a. Reimbursement of Unemployment Benefits Paid
The above organization elects to reimburse the Unemployment Insurance Fund an amount equal to the amount of regular benefits and of one-
half of the extended benefits paid that is attributable to service performed by former employees of the above organization. This election
requires the filing of quarterly employment and wage reports.
b. Payment of Quarterly Contributions
The above organization elects to file quarterly reports and pay any contributions as required by Section 35A-4-302 of the Utah Employment
Security Act. The following information is needed to determine the tax rate.
14. Enter below the amount of wages you have paid in Utah. If you have not paid wages enter “NONE”.
Jan. 1 to Mar. 31
Apr. 1 to Jun. 30
Jul. 1 to Sep. 30
Oct. 1 to Dec. 31
Current
Year:
Preceding
Year:
15. If you have not paid wages, do you expect to pay wages in the future?
Yes
No Estimated date ___________________________
I certify that I have authority to act as agent for the above organization. The information contained in this report is true and correct.
(
)
Authorized Agent
Title
Telephone
Date
DWS-U1
Form 1G
Rev. 5/01
INSTRUCTIONS
The Utah Employment Security Act provides that the Department of Workforce Services must determine the status under the
Act of each business and each person independently established in a trade, occupation, or profession in Utah. This report is to be
completed immediately and returned to P.O. Box 45288, Salt Lake City, Utah 84145-0288.
All items must be completed. If an item does not apply to your organization, enter N/A (not applicable).
Except as indicated below, all items are self-explanatory.
Item 5. Name and address of accountant or other agent to whom quarterly tax reports are to be sent (if different from Item 4).
Item 6. Name and address of agent who is able to provide information concerning wages paid and reasons for employees’
separation from your employment.
Item 7. Give street address, city, state and zip code. If you have more than one work location, give the address where the largest
number of your employees work.
Item 13A. Selection of this option will require that your organization reimburse the Unemployment Insurance Fund for the actual
amount of unemployment paid to your former employees. You will receive a detailed billing each month showing the benefits paid
to each individual for the prior month.
Item 13B. Selection of this option will require that your organization submit a quarterly contribution (tax) report and pay a quarterly
contribution to the Unemployment Insurance Fund. The contribution (tax) is calculated by multiplying the taxable wages paid during
the quarter by the contribution rate. The rate is initially determined by using an existing rate which prevails for employers in your
general business classification. After a fiscal year of experience (July 1 - June 30), your rate for the next calendar year will be
determined by the experience or history of benefits being paid to your former employees and taxable wages from your organization
for the same benefit period.
If your organization is determined to be subject to the Utah Employment Security Act, your organization will be required to submit a
quarterly list of employees showing each individual’s social security number, name, and quarterly gross earnings. This is required
regardless of the election for reimbursable or contributing coverage.
Item 14. The definition of wages is currently defined by Section 3306(b), of the Internal Revenue Code of 1986, with modifications,
subtractions, and adjustments provided in Section 35A-4-208 Subsections (2), (3), and (4), of the Utah Employment Security Act
with regard to how the wage base is determined. Wages means all remuneration for employment including commissions, bonuses,
salaries or draws to corporate officers, tips and the cash value of all remuneration in any medium other than cash.
Earnings of elected officials, members of the judiciary, persons in advisory or policy-making decisions, and persons serving on a
temporary basis in case of fire, storm, snow, earthquake, flood or similar emergencies, are not to be included on this report or any
required quarterly reports.
If additional information is needed, please call 801-526-9400 or 1-800-222-2857 ext. 9400 (Instate toll free number).
Fax 801-526-9377.
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