Printable State Form 54244 640P Details

Most people file their taxes every year without incident. However, there may be some taxpayers who find themselves in a position where they need to file an amended return. If this is the case for you, Form 54244 is what you will need to use. This form is used to notify the Internal Revenue Service (IRS) of changes made to your tax return after it has been filed. Keep in mind that filing an amended return can result in additional taxes owed, so be sure to consult with a tax professional before making any changes.

We've compiled some basic information about the form 54244. It's a good idea that you read this information before you decide to begin working with the PDF.

QuestionAnswer
Form NameForm 54244
Form Length1 pages
Fillable?Yes
Fillable fields36
Avg. time to fill out7 min 31 sec
Other namesindiana unemployment form 54244 640p, protest form workforce, indiana unemployment application, 54244 640p

Form Preview Example

UNEMPLOYMENT INSURANCE PROTEST (EMPLOYER)

State Form 54244 (R5 / 2-17), DWD 640-P

INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT

CONFIDENTIAL RECORD PURSUANT TO IC 22-4-19-6, IC 4-1-6

RECEIVE AND PROTEST UI CLAIM NOTICES

ELECTRONICALLY with

SIDES (State Information Data Exchange System)

For more information and to register visit

in.gov/dwd/sides.htm

*This agency is requesting the disclosure of the claimant's Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Claimant

 

 

 

 

Social Security Number

Benefit Year End

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claimant Street Address, City, State and ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

Indiana SUTA (Employer Account Number)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer Address, City, State and ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employee worked from:

 

to last day worked:

 

 

 

 

mm/dd/yyyy

 

 

 

 

 

 

mm/dd/yyyy

 

Brief Statement of Facts

regarding separation:

NOTE: If the claimant is separated due to Layoff, Lack of work or the assignment ending, you do not need to complete

this form or protest the claim.

Claimant never worked here OR unable to locate this claimant. (Code 52827)

Change of ownership/Predecessor-Successor/Out of business. (Code 527)

Agent no longer represents this company. (Code 52227)

Former PEO client OR Successor after a merger / acquisition. (Code 527)

Reason for Separation (choose one):

 

 

 

Quit - (Code 10)

 

Discharge for Cause - (Code 20)

 

Gross Misconduct - (Code 30)

 

Availability - (Code 70)

 

Failed/Refused Drug Test - (Code 30)

 

Employment Status - (Code 70)

 

Still Employed - (Code 70)

 

School Worker - (Code 70)

Work Refusal or Failed Pre-employment Drug Test - (Code 70) Did the claimant receive income upon separation or thereafter? - (Code 70)

Include specific information in statement section and/or attach documents to this submission.

Vacation

Severance

Sick

Personal

Pension/401k

Wages

Other

Please note: You will receive additional requests from the UI Adjudication Center seeking specific details concerning the employee's separation. Please respond to these requests as quickly as possible. Failure to respond to requests from the department can result in a penalty, even if the employee is later determined ineligible.

Contact Name of Employer

 

Date

 

 

 

 

 

mm/dd/yyyy

Signature of Employer

 

 

Telephone

 

Check here if you are attaching additional supporting documents to this fax, total number of additional pages:

Fax Form to: UI Adjudications at 317-233-5499

How to Edit Form 54244

It is really simple to fill out the state form 54244 spaces. Our PDF tool will make it practically effortless to complete any specific PDF file. Down below are the only four steps you need to take:

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The PDF document you decide to fill in will contain the next areas:

filling in state 54244 640p step 1

Enter the appropriate information in Contact Name of Employer, Signature of Employer, Date, Telephone, mm/dd/yyyy, Check here if you are attaching, and Fax Form to: UI Adjudications at field.

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