Michigan Form Uia 1015 C – Fill Out and Use This PDF

The Michigan UIA 1015-C form is a comprehensive questionnaire designed by the State of Michigan's Unemployment Insurance Agency. This form is intended for workers to outline their employment status, helping to clarify eligibility for unemployment benefits. It gathers extensive information ranging from personal and employer details to the nature of the work performed, work conditions, payment, and other employment-related questions.

For those seeking to establish or clarify their employment status with an employer, it's crucial to complete and submit the Michigan UIA 1015-C form accurately. Click the button below to begin the process of filling out your form.

Get Form Now Download PDF

Michigan Form Uia 1015 C PDF Details

In the landscape of unemployment benefits within Michigan, the UIA 1015-C form emerges as a pivotal document, sanctioned under MCL 421.1 et seq., and administered by the State of Michigan's Unemployment Insurance Agency (UIA), a sector of Licensing and Regulatory Affairs. This form serves as a comprehensive questionnaire tailored for workers to elucidate their employment status, thereby facilitating the accurate processing of their unemployment claims for a specific calendar year. The completion of this form, while voluntary, is critical; it assists in determining whether an individual was an employee of the mentioned company or self-employed during the period in question. Should individuals refrain from providing the requested information, there exists a risk of a determination being made without their input, potentially affecting the outcome of their claim. This document inquires about various aspects of the worker's role, including the nature of the services provided, the duration and location of these services, and the existence of any formal agreements. Furthermore, it delves into financial nuances, such as payment methods, deductions, and possible benefits like health insurance or workers' disability compensation insurance. The UIA 1015-C form not only requests detailed employment information but also invites additional comments, allowing claimants to furnish any supplementary data they deem beneficial for ascertaining their employment status. With a strict submission deadline, clear typing or printing of answers, and a certification of truth at the conclusion, this form epitomizes the structured approach Michigan takes to uphold the integrity and accuracy of claims within its unemployment insurance system.

Question	Answer
Form Name	Michigan Form Uia 1015 C
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	1015 C_268829_7 michigan uia invoices online form

Form Preview Example

UIA 1015-C	STATE OF MICHIGAN	Authorized by
(Rev. 5-11)	STATE OF MICHIGAN	MCL 421.1, et seq.
(Rev. 5-11)		MCL 421.1, et seq.
	LICENSING AND REGULATORY AFFAIRS	Completion of this
	UNEMPLOYMENT INSURANCE AGENCY	form is voluntary.
	UNEMPLOYMENT INSURANCE AGENCY

www.michigan.gov/uia

WORKER’S QUESTIONNAIRE TO DETERMINE EMPLOYMENT STATUS

For Calendar Year(s)

________________________Case Number

Date __________________________

Worker’s Name, Address, and Social Security Number

Company’s Name and Address

Employer Federal ID Number (if known):

Completing this form will help us determine your employment status with the above employer and assist us in processing your claim for unemployment beneits. FAILURE TO PROVIDE THIS INFORMATION MAY RESULT IN A DETERMINATION BEING MADE WITHOUT YOUR PARTICIPATION. Type or print your answers clearly and return this form within 10 days from the above date to:

(Indicate address where form should be returned)

If you have questions contact _____________________________________________	___________________________________
(Please print name)	(Telephone Number)

1.Did you consider yourself: (Indicate A or B and give reason for your answer)

A.An employee of the above-named company?_______________________________________________________

_____________________________________________________________________________________________

B.Self-Employed?______________________________________________________________________________

_____________________________________________________________________________________________

2.	Are you still performing services for this employer	YES	NO

	If NO, do you expect to return to work with this employer?	YES	NO
	If YES, give dates of employment __________________________________________________________________

3.	..............Has a previous ruling regarding your employment status with this employer been issued?	YES	NO
	If YES, who issued the ruling and when was ruling issued? ______________________________________________
	(Attach copy of ruling)

4.What is the employer’s business? __________________________________________________________________

_____________________________________________________________________________________________

5.How did you obtain work with this employer?__________________________________________________________

_____________________________________________________________________________________________

6.What service(s) did you perform?___________________________________________________________________

_____________________________________________________________________________________________

7.Where were the service(s) performed? (Give address) __________________________________________________

_____________________________________________________________________________________________

8. Was the work performed under a written agreement?	YES	NO
If YES, attach a copy of agreement.
9. Did you perform similar services for others while performing services for this employer	YES	NO

If YES, please provide the name(s) of other individuals for whom you have provided similar services in the last twelve months __________.

Page 1 of 3

10.	Did others perform similar services for this employer?	YES	NO
	If YES, how many? __________
........................................................................11. Did you submit invoices for the work you performed?		YES	NO
	If YES, please provide copies of invoices/bills that you submitted.
12.	Could either you or the employer terminate the services you performed at any time?	YES	NO
12.		YES	NO

Explain _______________________________________________________________________________________

_____________________________________________________________________________________________

13.What equipment, tools, expenses, materials, and/or supplies were provided to you by the employer to perform these services?

_____________________________________________________________________________________________

14.What equipment, tools, materials and/or supplies did you provide to perform these services? ____________________

_____________________________________________________________________________________________

15.

Did the employer reimburse you for any expenses you incurred?

YES

Please explain your answer _______________________________________________________________________

_____________________________________________________________________________________________

16. Were you required to report to work at a speciied time: e.g., 8:00 a.m. - 5:00 p.m.?

YES

If YES, who determined the hours? _________________________________________________________________

Who kept records of hours worked?_________________________________________________________________

17.

Were you required to call someone if you were unable to report to work?

YES

If YES, who?___________________________________________________________________________________

18.

How did you report your time to the company? Time clock

Sign-in sheet

Other

If other, indicate reporting method and who provided it? ________________________________________________

19.

Did the employer direct and control your day-to-day activities?

YES

(Did the employer tell you what to do, when and how to do it?)

If YES, how?___________________________________________________________________________________

_____________________________________________________________________________________________

20.

Was there a supervisor on the job that you reported to?

YES

If YES, who? _________________________________

21.

Did you employ assistants?

YES

(If YES, answer A through C. If NO, go to #22.)

A. Were the assistant’s subject to employer’s approval?

YES

B. Do you determine the hours that assistants work?

YES

C. How was the assistants’ pay determined? _________________________________________________________

22.

Was your job reviewed for satisfactory performance?

YES

If YES, who performed review? ____________________________________________________________________

Who paid for the expenses of correcting unsatisfactory work? ____________________________________________

23.How much were you paid for the services you performed? (Be speciic; e.g., $8.50 per hour [salary, commission, piece, square foot, etc.].) _________________________________________________________________________

_____________________________________________________________________________________________

24.How was the pay rate determined? _________________________________________________________________

_____________________________________________________________________________________________

Page 2 of 3

25.

Were deductions taken out of your paycheck:

e.g., income tax, social security withholding, etc.?

YES

If YES, identify deduction(s) _______________________________________________________________________

26.

Did you receive a W-2?

YES

Indicate year(s) ________________

27.

Did you receive a 1099?

YES

Indicate year(s) ________________

28.

................................................Were you covered by Workers’ Disability Compensation Insurance?

YES

If YES, who paid for coverage? ____________________________________________________________________

29. Did you receive any beneits: e.g., health insurance, life insurance, sick pay, vacation pay, etc?

YES

If YES, list beneits ______________________________________________________________________________

30. Did you have a Federal Employer Identiication Number (FEIN)?

YES

If YES, give number _____________________________________________________________________________

31. Did you ile an “assumed” name?

YES

If YES, what county ______________________________________________________________________________

32.

Did you pay state, federal, social security and Medicare taxes as

a self-employed individual?

YES

33. Did you ile a business income tax return?

YES

If YES, what is the title of the form? (For example, Schedule C, Form 1120) _________________________________

34.

Were you licensed?

YES

If YES, by which organization(s) are you licensed? _____________________________________________________

If not licensed in your name provide name, type of license, organization, etc. _________________________________

35. Did you maintain an ofice or other place of business?

YES

If YES, what is the address? ______________________________________________________________________

If YES to #35, did the employer pay any part of the rent? ________________________________________________

36.

Did you advertise as being available to the general public by listing your services

in the telephone directory or and other publications?

YES

If YES, identify _________________________________________________________________________________

38.ADDITIONAL COMMENTS: (In the space below, you may provide any additional information you feel would be beneicial in determining your employment status. Use reverse if necessary.)

______________________________________________________________________________________________

CERTIFICATION

I hereby certify that the answers given on this form are true and complete to the best of my knowledge and belief.

_______________________________________________	_______________________	______________________________
Signature	Date	Telephone Number

(Include Area Code)

LARA is an equal opportunity employer/program.

Page 3 of 3

How to Edit Michigan Form Uia 1015 C Online for Free

You'll be able to fill in Michigan Form Uia 1015 C without difficulty by using our PDFinity® online tool. FormsPal development team is continuously working to expand the editor and help it become much better for users with its multiple functions. Take your experience to another level with constantly developing and interesting opportunities available today! Should you be looking to get started, here is what it will require:

Step 1: Firstly, access the pdf editor by clicking the "Get Form Button" in the top section of this page.

Step 2: With our handy PDF tool, you're able to do more than just fill out blank form fields. Edit away and make your docs look faultless with custom text incorporated, or optimize the file's original content to perfection - all that comes with an ability to incorporate any photos and sign the PDF off.

When it comes to fields of this particular form, this is what you should consider:

1. Start completing the Michigan Form Uia 1015 C with a number of necessary blanks. Gather all of the necessary information and be sure not a single thing forgotten!

Completing part 1 in Michigan Form Uia 1015 C

2. Soon after the last array of blank fields is completed, go on to enter the relevant information in all these - Are you still performing services, NO NO, Has a previous ruling regarding, If YES who issued the ruling and, What is the employers business, How did you obtain work with this, What services did you perform, Where were the services performed, Was the work performed under a, If YES attach a copy of agreement, Did you perform similar services, months, and Page of.

months, How did you obtain work with this, and Did you perform similar services in Michigan Form Uia 1015 C

3. This next part is going to be hassle-free - fill out all the fields in Did others perform similar, Were deductions taken out of your, If YES how many, Did you submit invoices for the, Could either you or the employer, Explain, What equipment tools expenses, services, What equipment tools materials, Did the employer reimburse you, Please explain your answer, Were you required to report to, If YES who determined the hours, Were you required to call someone, and eg income tax social security to conclude this part.

Could either you or the employer, What equipment tools materials, and What equipment tools expenses of Michigan Form Uia 1015 C

Always be very careful when filling out Could either you or the employer and What equipment tools materials, because this is the section in which most users make some mistakes.

4. Your next section requires your attention in the following areas: Were you required to call someone, If YES who, How did you report your time to, Signin sheet, Other, If other indicate reporting method, Did the employer direct and, If YES how, Was there a supervisor on the job, If YES answer A through C If NO go, If not licensed in your name, If YES what is the address, If YES to did the employer pay, Did you advertise as being, and in the telephone directory or and. Always enter all of the requested info to move onward.

Completing section 4 in Michigan Form Uia 1015 C

5. The final step to submit this document is pivotal. Make sure to fill in the necessary fields, such as How was the pay rate determined, I hereby certify that the answers, Signature, Date, Telephone Number Include Area Code, Page of, LARA is an equal opportunity, and Page of, before using the form. In any other case, it may generate an unfinished and probably unacceptable document!

Step # 5 in submitting Michigan Form Uia 1015 C

Step 3: Look through what you've typed into the blanks and click the "Done" button. Acquire your Michigan Form Uia 1015 C as soon as you sign up at FormsPal for a free trial. Easily get access to the document inside your FormsPal account page, together with any edits and adjustments all kept! FormsPal guarantees your data privacy via a secure system that never records or distributes any type of personal information involved in the process. Be assured knowing your files are kept safe any time you use our tools!

Michigan Form Uia 1015 C – Fill Out and Use This PDF

Michigan Form Uia 1015 C PDF Details

Form Preview Example

How to Edit Michigan Form Uia 1015 C Online for Free

Michigan Form Uia 1015 C isn’t the one you’re looking for?

Related Documents