State Form 54244 PDF Details

The State Form 54244 is a document used to report the actions of an uncooperative taxpayer. This form can be used to report taxpayers who are not following the tax laws, or who are refusing to cooperate with the state or federal government in regards to their taxes. By using this form, you can help protect your rights and ensure that the taxpayer is held accountable for their actions.

Below are some facts you may want to review before starting working with the state form 54244.

QuestionAnswer
Form NameState Form 54244
Form Length1 pages
Fillable?Yes
Fillable fields20
Avg. time to fill out4 min 19 sec
Other namesstate form 54244 download 640p, state form 54244, 54244, indiana state form 54244 640p

Form Preview Example

UNEMPLOYMENT INSURANCE PROTEST (EMPLOYER)

State Form 54244 (R6 / 5-20), DWD 640-P

INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT

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

Reset Form

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

Claimant Street Address, City, State and ZIP Code

Social Security Number

Benefit Year End

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Agent no longer represents this company.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 65)

 

Work Refusal - (Code 35)

 

Deductible Income - (Code 55)

Did the claimant receive income upon separation or thereafter? - (Code 55)

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 State Form 54244 Online for Free

The PDF editor was made with the intention of allowing it to be as effortless and easy-to-use as it can be. The next steps are going to make filling up the state form 54244 download 640p quick and simple.

Step 1: Select the button "Get Form Here" and click it.

Step 2: So, you're on the file editing page. You can add content, edit existing details, highlight specific words or phrases, put crosses or checks, add images, sign the template, erase unneeded fields, etc.

For each area, add the content required by the platform.

indiana unemployment protest form 54244 fields to fill in

In the part Reason, for, Separation, choose, one Vacation, Severance, Sick, Personal, Pension, k Wages, and Other write down the details that the application demands you to do.

indiana unemployment protest form 54244 ReasonforSeparationchooseone, Vacation, Severance, Sick, Personal, Pensionk, Wages, and Other fields to fill out

Mention the key data in Contact, Name, of, Employer Signature, of, Employer Date, Telephone, mm, dd, yyyy and Fax, Form, to, UI, Adjudication, s, at box.

indiana unemployment protest form 54244 ContactNameofEmployer, SignatureofEmployer, Date, Telephone, mmddyyyy, and FaxFormtoUIAdjudicationsat blanks to complete

Step 3: If you are done, select the "Done" button to export the PDF form.

Step 4: You may create copies of your form toprevent all of the possible future troubles. Don't be concerned, we cannot disclose or check your data.

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