Blank Illinois Ui Ha PDF Form

Blank Illinois Ui Ha PDF Form

The Illinois UI Ha form is a report used by household employers to detail wages paid to their employees for unemployment insurance purposes. This form requires specific information, such as your Illinois Unemployment Insurance Account Number, your Federal Employer Identification Number, and details about your employees, including their names and Social Security numbers. Completing this form accurately is essential for compliance, so please ensure you fill it out by clicking the button below.

The Illinois UI Ha form serves as a crucial document for employers who hire household employees. It collects essential information, including the employer's Illinois Unemployment Insurance Account Number and Federal Employer's Identification Number (FEIN). Employers must provide their name and address, ensuring that the form is sent to the correct location. Each household employee's details must be recorded, including their full name and Social Security number. The form requires employers to report total wages paid to each employee for each quarter of the year, with specific instructions for entering amounts, including salaries, commissions, and other forms of remuneration. If an employer has more than eight household employees, additional sheets may be needed to capture all necessary information. The form also outlines how to calculate taxable wages and contributions due, emphasizing the importance of reporting accurately to avoid penalties. Employers must sign the report and may need to attach a Power of Attorney if someone else signs on their behalf. Finally, it provides instructions for payment and filing deadlines, ensuring compliance with state requirements.

Document Sample

UI-HA Report for Household Employers Instructions

You may file on-line at https://taxnet.ides.state.il.us

Step 1

Line 1a Enter your 7-digit Illinois Unemployment Insurance Account Number.

Line 1b Enter the nine digit Federal Employer's Identification number (FEIN) assigned to you by the Internal Revenue Service.

Line 2 Enter your first name, middle initial and last name.

Line 3 Enter the street address including the city, state and zip code where you want to receive this form.

Step 2

Lines 6 through 14 - use one line for each employee

Column A

Print the last and first name(s) of your household employee(s).

Column B

Complete this item by copying your employee’s social security number from his or her Social Security card.

Columns C through F (quarters)

Enter the total wages paid to each employee for each quarter of the year. If no wages were paid for that quarter, please enter "0".

Wages include (a) salaries, commissions and bonuses, tips reported to the employer, separation pay, vacation pay, prizes, sick pay, payments on account of retirement; (b) the reasonable cash value of remuneration paid other than cash, such as goods, meals and lodging; and (c) any remuneration for services performed within the State which is considered wages under the Federal Unemployment Tax Act.

Line 15 If you had more than eight household employees during 2012, use an additional sheet of paper and include the information in Step 2 for each additional worker. Total each Column C through F on the attachment, and write the totals on Line 15 in the appropriate column.

Line 16a Add Lines 6 through 15 within each column. This is the total wages paid for each quarter.

Step 3

Line 16b Copy totals from line 16a above.

Line 17 Write in the total wages paid in excess of the unemployment insurance taxable wage base amount for each worker. For 2012, the taxable wage base amount is $13,560 for each worker.

An employer must pay unemployment insurance contributions on only the first $13,560 in wages for each employee.

Example: You have one household employee that you pay $5,000 each quarter. During the first and second quarter, the wages paid to the employee total $10,000, so you would enter “0” in each column for the first and second quarters. During the third quarter, the total amount paid to the employee reaches $15,000 which exceeds the $13,560 unemployment insurance taxable wage base by $1,440. So the amount to be entered on Line 17 for the third quarter, is $1,440 ($15,000-$13,560). The fourth quarter wages of $5,000 must be entered on Line 17 for the fourth quarter since the wage base was met during the third quarter.

 

1st quarter

2nd quarter

3rd quarter

4th quarter

 

 

 

 

 

Ex Line 17

$ 0

$ 0

$1,440

$5,000

 

 

 

 

 

UI-HA instructions (12/12)

Step 3 continued

Line 18 Subtract Line 17 from Line 16b and enter the result on Line 18. These are your taxable wages.

Lines 19 and 20

For each quarter, calculate your unemployment insurance contribution. Within each column, complete either Line 19 or 20, whichever is applicable.

Line 21 Quarter totals: Enter the amount from Line 19 or 20 in each column. This is your contribution due for each quarter.

Line 22. Grand total. Add the quarterly totals from Line 21 (Columns C, D, E and F) and enter the result on Line 22. This is your 2012 total

unemployment insurance contributions due.

Step 4

Line 23-26 Enter the total number of employees (full or part time) who are covered by unemployment insurance and who performed services during or received pay for the payroll period including the 12th of

each month of the quarter. Include workers who have earned more than $13,560 in the calendar year and those on vacation or paid

sick leave. Exclude workers on strike.

Step 5

Line 27 Write the amount shown on line 22. This is your total 2012 unemployment insurance contribution.

Line 28 Write the amount of any previous payment made to the Illinois Department of Employment Security for the liability shown on Line 27.

Line 29 Subtract Line 28 from Line 27.

This is the amount of unemployment insurance contribution due.

Make your check payable to the Illinois Department of

Employment Security.

Step 6

Line 30 If you have stopped employing workers, write the date of the last day you employed workers.

Step 7

Line 31 This report must be signed by the person named in Step 1, Line 2. If signed by any other person, a Power of Attorney must be attached.

MAIL YOUR COMPLETED REPORT ALONG WITH YOUR CHECK TO:

ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY PO BOX 3637

SPRINGFIELD IL 62708-3637

General Instructions

What if I do not file or pay by the due date?

If you do not file a processable return or pay the tax you owe by the due date, you will owe penalty and interest.

What if I need to correct information I reported? Where may I obtain help or more information?

For other related forms or help with questions regarding unemployment insurance, please call the Unemployment Insurance Hotline toll-free at 1 800 247-4984 (option 2).

The TTY number for the hearing impaired is (866) 212-8831.

UI-HA instructions (12/12)

State of Illinois

Form UI-HA Report for Household Employers

Step 1: Tell us about yourself

Illinois Department of Employment Security

File on-line at https://taxnet.ides.state.il.us

1a ________________________________ b ___ ___–___ ___ ___ ___ ___ ___ ___

Illinois account number (Unemployment Insurance)

Federal employer’s identification number

 

2___________________________________________________________________

Your name (first, middle initial, last)

3___________________________________________________________________

Street Address

___________________________________________________________________

City

State

Zip

Step 2: Report your household employee information

5For unemployment insurance reporting, complete Columns A-F

6

A

 

B

 

C

 

D

 

E

 

F

 

Name

Social

1/2012

 

2/2012

 

3/2012

 

4/2012

 

 

(last, first)

Security No.

 

QTR. ending Mar. 31

 

QTR. ending June 30

 

QTR. ending Sept. 30

 

QTR. ending Dec. 31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

_____________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

Other (attach) ________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16a Column totals: Add Lines 7 through 15 in each column

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 3: Figure your unemployment insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

contribution due for each quarter

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1st quarter

 

 

2nd quarter

 

 

3rd quarter

 

 

4th quarter

 

16b Column totals: Copy totals from line 16a above.

 

 

______________________

______________________

______________________

_____________________

17Write the total wages paid in excess of the taxable

 

wage base amount ($13,560 per employee for 2012).

______________________

______________________

______________________

_____________________

18

Subtract Line 17 from Line 16b.

______________________

______________________

______________________

_____________________

19

If Line 16a is less than $50,000, multiply Line 18 by

______________________

______________________

______________________

_____________________

 

your 2012 contribution rate or 5.400%, whichever is less.

 

 

 

 

 

 

20

If Line 16a is $50,000 or more, multiply Line 18 by

______________________

______________________

______________________

_____________________

 

your 2012 contribution rate.

 

 

 

 

 

 

21

Quarter totals: Enter the amount from Line 19 and/or 20.

______________________

______________________

______________________

_____________________

22

Grand total: Add the quarter totals from Line 21 (Columns C, D, E and F) and write the result on Line 22.

 

 

22

_________________

UI-HA front 1 of 2 (12/12)

PLEASE RETURN THIS PAGE AND PAGE 2 OF THIS FORM

 

Step 4: Number of employees who are covered for unemployment insurance

Write the total number of covered workers (full and part time) who performed services during or received pay for the payroll period including the 12th of each month of each quarter. If none, write “0”

23

1st quarter

A

January 12

__________

B

February 12

__________

C

March 12

___________

24

2nd quarter

A

April 12

__________

B

May 12

__________

C

June 12

___________

25

3rd quarter

A

July 12

__________

B

August 12

__________

C

September 12

___________

26

4th quarter

A

October 12

__________

B

November 12

__________

C

December 12

___________

Step 5: Figure your total unemployment insurance contribution due

27

Write the amount from Line 22.

27

____________I ____

28

Write the amount of any previous payment to the Illinois Department of Employment Security for the liability shown on Line 27.

28

____________I ____

29

Subtract Line 28 from Line 27. Make your check payable to the Illinois Department of Employment Security.

29

____________I ____

 

 

 

 

Step 6: Complete if you are no longer employing workers

 

 

 

30

Write the date you stopped employing workers.

30

____/_____/____

 

 

 

 

month day year

 

 

 

 

 

Step 7: Sign below

Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, it is true, correct, and complete.

31 ____________________________________________________________

____/____/__________

(_____) ______________

Household employer’s signature (full name)

month day

year

Daytime telephone number

Filing deadline: April 15, 2013

You may file and pay on-line at https://taxnet.ides.state.il.us

Mail your completed report along with your check to:

ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY

PO BOX 3637

SPRINGFIELD IL 62708-3637

UI-HA back 2 of 2 (12/12)

This state agency is requesting information that is necessary to accomplish the statutory purpose as outlined under 820 ILCS405/100-3200. Disclosure of this information is REQUIRED. Failure to disclose this information may result in statutorily prescribed liability and sanction, including penalties and or interest. This form has been approved by the Forms Management Center.

PLEASE RETURN THIS PAGE AND PAGE 1 OF THIS FORM

File Specifics

Fact Name Details
Account Numbers Employers must provide their 7-digit Illinois Unemployment Insurance Account Number and a 9-digit Federal Employer's Identification Number (FEIN).
Employee Information Employers are required to list the names and Social Security numbers of their household employees.
Wage Reporting Wages paid to each employee must be reported for each quarter. If no wages were paid, enter "0".
Taxable Wage Base For 2012, the taxable wage base amount is $13,560 per employee. Employers only pay contributions on wages up to this amount.
Filing Requirements The form must be signed by the employer or an authorized person. A Power of Attorney is needed if signed by someone else.
Governing Law This form is governed by the Illinois Unemployment Insurance Act, specifically under 820 ILCS 405/100-3200.

How to Use Illinois Ui Ha

Completing the Illinois UI-HA form is a straightforward process. Follow the steps below to ensure you fill it out correctly. Make sure to have all necessary information on hand before you start.

  1. Enter your 7-digit Illinois Unemployment Insurance Account Number.
  2. Provide your 9-digit Federal Employer's Identification Number (FEIN) assigned by the IRS.
  3. Fill in your first name, middle initial, and last name.
  4. Write your street address, city, state, and zip code where you want to receive this form.
  5. List the last and first names of your household employees, using one line for each employee.
  6. Copy your employee’s social security number from their Social Security card.
  7. Enter the total wages paid to each employee for each quarter of the year. If no wages were paid for that quarter, enter "0".
  8. If you had more than eight household employees during 2012, use an additional sheet to provide the same information for each additional worker.
  9. Total each Column C through F on the attachment and write the totals on Line 15 in the appropriate column.
  10. Add Lines 6 through 15 within each column to find the total wages paid for each quarter.
  11. Copy totals from Line 16a above.
  12. Write in the total wages paid in excess of the unemployment insurance taxable wage base amount ($13,560 for each worker in 2012).
  13. Subtract Line 17 from Line 16b and enter the result on Line 18. These are your taxable wages.
  14. Calculate your unemployment insurance contribution for each quarter by completing either Line 19 or 20, whichever is applicable.
  15. Enter the amount from Line 19 or 20 in each column. This is your contribution due for each quarter.
  16. Add the quarterly totals from Line 21 (Columns C, D, E, and F) and enter the result on Line 22. This is your total unemployment insurance contributions due for 2012.
  17. If you have stopped employing workers, write the date of the last day you employed workers.
  18. Sign the report. If someone else is signing, attach a Power of Attorney.
  19. Mail your completed report along with your check to the Illinois Department of Employment Security at the provided address.
  20. Write the total number of employees covered by unemployment insurance who performed services during or received pay for the payroll period including the 12th of each month of the quarter.
  21. Write the amount shown on Line 22 as your total 2012 unemployment insurance contribution.
  22. Write the amount of any previous payment made to the Illinois Department of Employment Security for the liability shown on Line 27.
  23. Subtract Line 28 from Line 27. This is the amount of unemployment insurance contribution due.
  24. Make your check payable to the Illinois Department of Employment Security and send it with the report.

Your Questions, Answered

What is the Illinois UI-HA form?

The Illinois UI-HA form is a reporting document used by household employers to report unemployment insurance contributions for their employees. It includes details about wages paid, employee information, and the employer's identification numbers. This form is essential for compliance with state unemployment insurance laws.

Who needs to fill out the UI-HA form?

Household employers in Illinois who have employees performing services must complete the UI-HA form. This includes anyone who pays individuals for work done in their home, such as caregivers, housekeepers, or gardeners. If you have employees who earned wages during the reporting period, you are required to file this form.

What information is required on the UI-HA form?

The form requires several key pieces of information:

  1. Your 7-digit Illinois Unemployment Insurance Account Number.
  2. Your 9-digit Federal Employer Identification Number (FEIN).
  3. Your name and address where you want to receive the form.
  4. The names and Social Security numbers of your household employees.
  5. The total wages paid to each employee for each quarter.

Make sure to report accurate figures to avoid penalties.

How do I calculate the taxable wages for my employees?

To calculate taxable wages, first, determine the total wages paid to each employee for the year. For 2012, only the first $13,560 in wages per employee is subject to unemployment insurance contributions. If an employee's wages exceed this amount, the excess must be reported on the form. For example, if an employee earns $15,000 in a quarter, you would report $1,440 as taxable wages for that quarter.

What happens if I do not file the UI-HA form on time?

If the UI-HA form is not filed by the due date, you may incur penalties and interest on the unpaid taxes. Timely filing is crucial to avoid these additional costs. It is advisable to file the form online or by mail as soon as possible to ensure compliance.

Where do I send the completed UI-HA form?

Once you have completed the UI-HA form, mail it along with your check to:

Illinois Department of Employment Security
PO Box 3637
Springfield, IL 62708-3637

Ensure that you keep a copy for your records.

Who can I contact for assistance with the UI-HA form?

If you have questions or need assistance, you can call the Unemployment Insurance Hotline at 1-800-247-4984 (option 2). For hearing-impaired assistance, the TTY number is 1-866-212-8831. Additionally, you can find more information and resources on the Illinois Department of Employment Security website.

Common mistakes

  1. Incorrect Account Numbers: Many people mistakenly enter an incorrect 7-digit Illinois Unemployment Insurance Account Number or Federal Employer's Identification Number (FEIN). Double-check these numbers to ensure accuracy.

  2. Missing Employee Information: Some individuals forget to list all household employees. Each employee's name and social security number must be included. Omitting even one can lead to complications.

  3. Wage Reporting Errors: Failing to accurately report total wages paid for each quarter is a common mistake. Remember to enter "0" if no wages were paid during a quarter.

  4. Incorrect Taxable Wage Base Amount: Some filers miscalculate the amount exceeding the taxable wage base of $13,560. It’s crucial to understand how to calculate this correctly to avoid penalties.

  5. Signature Issues: The report must be signed by the person named in Step 1. If someone else signs, a Power of Attorney must be attached. Failing to follow this requirement can delay processing.

  6. Missing Filing Deadline: Many people overlook the filing deadline. Late submissions can result in penalties and interest. Be sure to file on time to avoid these issues.

Documents used along the form

The Illinois UI-HA form is an essential document for household employers to report unemployment insurance contributions. However, several other forms and documents may accompany it to ensure compliance with state regulations. Below is a list of related documents that are often used in conjunction with the UI-HA form.

  • Illinois Unemployment Insurance Contribution Rate Notice: This notice informs employers of their assigned contribution rate for the upcoming year. It is essential for calculating the unemployment insurance contributions accurately.
  • Employer's Quarterly Contribution and Wage Report (UI-3/40): This form is used to report wages paid to employees and the corresponding unemployment insurance contributions for each quarter. It provides a detailed account of employment activities.
  • Federal Employer Identification Number (FEIN) Application (Form SS-4): Employers must obtain a FEIN from the IRS to report taxes and hire employees legally. This form is necessary for tax reporting purposes.
  • Illinois Department of Employment Security (IDES) Registration Form: New employers must complete this form to register with the IDES for unemployment insurance. It collects basic information about the business and its owners.
  • Power of Attorney (Form IL-2848): If someone other than the employer is signing the UI-HA form, this document grants them authority to act on behalf of the employer. It ensures that the signature is legally valid.
  • Wage and Tax Statement (Form W-2): Employers must provide this form to employees at the end of the year, summarizing their earnings and taxes withheld. It is crucial for employees when filing their personal income tax returns.
  • Employee's Withholding Allowance Certificate (Form W-4): This form helps employers determine the correct amount of federal income tax to withhold from an employee's paycheck. It is essential for payroll processing.
  • Illinois New Hire Reporting Form: Employers are required to report newly hired employees to the state within a specific timeframe. This form helps in tracking employment for child support enforcement and other purposes.
  • Unemployment Insurance Claim Form: Employees may need to complete this form to file for unemployment benefits. It collects information about their employment history and the reason for unemployment.
  • IRS Form 941: Employers use this quarterly form to report income taxes, Social Security tax, and Medicare tax withheld from employee paychecks. It is essential for federal tax compliance.

Understanding these related forms can significantly aid household employers in navigating their responsibilities. Each document plays a vital role in ensuring compliance with both state and federal regulations. By staying organized and informed, employers can effectively manage their obligations and support their employees.

Similar forms

The Illinois UI-HA form shares similarities with the IRS Form 941, which is used by employers to report income taxes withheld from employees and the employer's share of Social Security and Medicare taxes. Both forms require employers to report wages paid to employees on a quarterly basis. Just as the UI-HA form specifies the total wages paid to household employees, Form 941 requires a detailed account of all wages, tips, and other compensation. Furthermore, both forms necessitate the inclusion of the employer’s identification numbers and the total number of employees covered during the reporting period. Accuracy is critical in both cases, as errors can lead to penalties or increased scrutiny from tax authorities.

Another document that resembles the Illinois UI-HA form is the state-specific Employer’s Quarterly Wage Report. This report is typically required by state labor departments to track the wages of employees for unemployment insurance purposes. Like the UI-HA form, it collects information about employee wages for each quarter, including the total amount paid to each employee. Employers must also provide their identification numbers and the number of employees covered under unemployment insurance. Both forms are essential for ensuring compliance with state regulations and for calculating unemployment contributions accurately.

The W-2 form, issued by employers to their employees, also shares some characteristics with the Illinois UI-HA form. While the W-2 summarizes an employee's annual wages and the taxes withheld, it is similar in that it requires detailed information about wages paid. Both forms necessitate accurate reporting of employee Social Security numbers and the total wages paid, which is crucial for tax purposes. Furthermore, both documents are integral to the employee’s tax filing process, ensuring that individuals have the necessary information to report their income correctly to the IRS.

Lastly, the Form 1099-MISC, used for reporting various types of income other than wages, aligns with the Illinois UI-HA form in its requirement for detailed income reporting. This form is typically used for independent contractors, but it also requires the reporting of total payments made, similar to how the UI-HA form requires reporting of wages for household employees. Both forms emphasize the importance of accurate information regarding payments and include the recipient's identification numbers. Compliance with these forms is vital to avoid potential penalties from the IRS or state tax authorities.

Dos and Don'ts

When filling out the Illinois UI Ha form, it’s important to follow specific guidelines to ensure accuracy and compliance. Here’s a list of dos and don’ts:

  • Do enter your 7-digit Illinois Unemployment Insurance Account Number accurately.
  • Do include the nine-digit Federal Employer's Identification Number (FEIN) assigned by the IRS.
  • Do write your full name, including your first name, middle initial, and last name.
  • Do provide a complete street address, including city, state, and zip code.
  • Don’t forget to list the last and first names of each household employee on separate lines.
  • Don’t skip entering the total wages paid for each employee for every quarter.
  • Don’t neglect to calculate and report any wages exceeding the taxable wage base amount.
  • Don’t sign the report unless you are the person named in Step 1, Line 2, or have attached a Power of Attorney.

Following these guidelines will help ensure that your form is processed correctly and efficiently.

Misconceptions

  • Misconception 1: The Illinois UI Ha form is only for large employers.
  • This form is applicable to all household employers, regardless of the number of employees. Even if you have only one employee, you must complete and submit the form.

  • Misconception 2: You can ignore reporting if no wages were paid in a quarter.
  • Even if no wages were paid, you must still report by entering "0" for that quarter. This ensures accurate record-keeping and compliance with state regulations.

  • Misconception 3: The taxable wage base is the same every year.
  • The taxable wage base can change annually. For 2012, it was $13,560, but this amount may differ in subsequent years. Always check for the current taxable wage base.

  • Misconception 4: You only need to report employees who worked all year.
  • All employees who performed services or received pay during the reporting period must be included, even if they did not work the entire year.

  • Misconception 5: You can submit the form without a signature.
  • The form must be signed by the individual listed in Step 1, Line 2. If someone else signs it, a Power of Attorney must be attached to validate the submission.

  • Misconception 6: You can file the form any time without penalties.
  • There are deadlines for filing the form. Failure to submit it on time can result in penalties and interest on any unpaid taxes.

  • Misconception 7: You can report wages in any format you choose.
  • The form has specific requirements for reporting wages, including the format and columns to use. Adhering to these guidelines is essential for accurate processing.

Key takeaways

When filling out the Illinois UI-HA form, there are several important points to keep in mind to ensure accuracy and compliance.

  • Account Information: Begin by entering your 7-digit Illinois Unemployment Insurance Account Number and the 9-digit Federal Employer's Identification Number (FEIN). These numbers are essential for proper identification.
  • Employee Details: List each household employee’s name and Social Security number. Make sure to copy the Social Security number directly from the employee’s card to avoid errors.
  • Wage Reporting: Report total wages paid to each employee for each quarter. If no wages were paid, simply write "0." Remember that wages include various forms of compensation, not just salary.
  • Taxable Wage Base: For 2012, the taxable wage base amount is $13,560 per employee. Only report wages exceeding this amount on the form, as unemployment insurance contributions are only required on the first $13,560.
  • Quarterly Calculations: Total the wages for each quarter and calculate your unemployment insurance contribution based on the provided rates. Ensure that you complete the appropriate lines for each quarter.
  • Submission Requirements: Sign the report and mail it along with your payment to the Illinois Department of Employment Security. If someone other than the employer signs the form, include a Power of Attorney.

By following these key points, you can accurately complete the Illinois UI-HA form and fulfill your reporting obligations effectively.