Ui28 2012 form-2026

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The document is a form (UI-28) from the State of Illinois Department of Employment Security for employers to file a claim for adjustment or refund of erroneously paid contributions, interest, or penalties. It outlines the necessary information required for submission, including employer details, basis of claim, and computation of overpaid amounts by quarter. The form must be signed by an authorized representative and submitted within three years of the erroneous payment.

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Click ‘Get Form’ to open the ui28 2012 form in the editor.
Begin by entering your Employer Name and Account Number as they appear on your contribution report. Ensure that your current address is accurately filled out.
In the BASIS OF CLAIM section, provide a detailed explanation of the overpayment. If more space is needed, attach additional sheets.
For the YEAR field, enter the applicable year for your claim. Remember to submit a separate form for each calendar year.
Proceed to the COMPUTATION section. For each quarter, input both the reported and corrected amounts for Total Wages, Less Wages in Excess, Taxable Wages, and any other relevant fields.
Finally, review all entries for accuracy before signing at the bottom of the form. Ensure it is signed by an authorized individual within your enterprise.

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