Ui 5G Form PDF Details

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Below are some particulars about ui 5g form. You'll have the estimated time you may need to fill in the form as well as extra details.

Form NameUi 5G Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesmt form ui 5 fillable, form ui 5 montana, unemployment motnana, unemployment claim montana

Form Preview Example

Step 1. Check
applicable boxes and provide information requested:

Montana Employer’s Unemployment Insurance (UI)



Quarter End

Due Date


Quarterly Wage Report – Form UI-5G













Employer Identification Numbers





UI Account Number












Federal ID (FEIN)












UI Contribution Rate






UI Administrative Fund Tax Rate





UI Total Tax Rate



A report must be filed even if no wages are paid. Instructions for completing this form are online at http://uid.dli.mt.gov/tax/uitaxforms.asp or call 406-444-3834. File online at UIeServices.mt.gov. If paying by check, please use attached voucher.

No Wages paid for the quarter covering this report

Sold Business Name, address and phone number of new owner: Ceased Employing Last payroll date ______/_____/_____

Change in Name, Address, Phone Number or Federal ID # (list corrections): _________________________________

Amended Report


Step 2. Unemployment Insurance Employee Wage Listing



Check here if wage listing is attached.
















Employee’s Social Security


Name of Employee


Total Wages





Last Name



First Name


Paid this Quarter
















































































































































































































Step 3. Calculate Tax




State Unemployment


Step 4. Number of










Insurance Tax


UI Employees












Total wages paid this quarter







Number of covered












UI total tax rate













workers who worked












Total tax (multiply line 1 times line 2)







during, or received pay for











the payroll period that


Credits (overpayment from prior quarters)













includes the 12th day of












Adjustments to prior quarters (attach explanation)











the month:












Balance due (line 3 line 4 +/- line 5 -- see instructions)






1st month ____________


If filing late, add penalty ($25) and interest (line 6 x 1.5% x month(s) past due)







2nd month ____________












Payment enclosed (line 6 + 7)

























3rd month


Make Check Payable to Unemployment Insurance Division. Please use attached voucher.




















Step 5. Signature. Sign and make a copy of this form for your records. Mail your report, additional wage listings and payment with voucher by the due date above, even if no wages are paid or tax is due. Questions? Call (406) 444-3834.










Mail to:


I certify the information on this report is true and correct.




Unemployment Insurance










Contributions Bureau









Authorized Signature


Telephone Number

Name/Title of Contact Person

Telephone No


PO Box 6339








Helena MT 59604-6339















Mail this form with your check and voucher to the Unemployment Insurance Contributions Bureau.

UI-5G Revised 7/13

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