Form uia 1718-2026

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Click ‘Get Form’ to open it in the editor.
Begin by entering your last name, first name, and middle initial in the designated fields. If you have worked under a different name or Social Security number, provide that information in the additional section.
Input your UIA Employer Account Number and Social Security Number accurately. Ensure there are no dashes when entering your SSN.
Fill in the employer's name, Federal Employer ID Number (from your W-2), complete address, and telephone number.
Record the first and last day you worked for this employer. If you never worked for them, check the appropriate box.
For each quarter listed, report your gross wages paid. You can enter pay dates and amounts if needed to calculate total quarterly wages.
Attach proof of income such as pay stubs or W-2s. Indicate whether you have this documentation and explain if not.
Finally, read the certification statement carefully before signing and dating the form to confirm accuracy.

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