Dependents Claim Form

Form Number: B-70

Information required to claim a dependency allowance.

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Dislocated Worker Benefits Training Verification Form

Form Number: B-100 (DWB)

Verification of attendance at training for Dislocated Worker Benefts claims.

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Dislocated Worker Benefits

Form Number: ETA-858A

Initial Application for Dislocated Worker Benefits.

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Oath Regarding Signature On Check

Form Number: BD-8

Affidavit form used to obtain signature samples and replace missing unemployment checks.

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Request for Commission Hearing for Income Tax Refund Offset

Form Number: UC-3

Used to request a commission hearing when an Income Tax Refund is being offset.

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Overpayment Waiver Information

Form Number: UIC-1

Information on how to request a waiver of an unemployment benefit overpayment through the Unemployment Insurance Commission.

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TAA-TRA Training Verification Form

Form Number: ETA-858A

Weekly Request for Benefits and/or Daily Travel/Subsistence Allowances (combined form) for Trade Readjustment Allowances and North American Free Trade Agreement Programs

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Employer's Election to Cover Multi-State Workers

Form Number: ME FX-RC1

For employers with workers in other states

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Power of Attorney Form

Form Number: ME UC-28

Gives a designated individual the power to represent an employer.

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Election to Cover as a Direct Reimbursement Employer

Form Number: ME C-24

Allows a qualifying employer to make direct reimbursement payments instead of contributions.

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Voluntary Election of Unemployment Coverage

Form Number: Me. FX-2

Allows an employer that does not have to make unemployment contributions to cover their employees for unemployment insurance.

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Termination of Coverage

Form Number: ME FX-3

Allows an employer whose liability conditions are no longer met, to terminate their account.

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Employment Relationship with Workers

Form Number: ME FX-8.1

This form is used to determine an employer's relationship with a worker for Unemployment Insurance tax purposes.

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Notice of Attempted Recall / Refusal

Form Number: ME B-12

Used to notifiy Unemployment operations of an attempted recall of a former employee or the former worker's refusal of a job offer.

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Employer Information on Maine Employment Security Law (Me. I-1.4)

Form Number: ME I-1-4

Advises employers of responsibilities under the Maine Employment Security law and provides a brief explanation of the more common forms that employers may receive.

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Treatment of Employee Leasing Companies under Maine Employment Security Law (Me. I-15)

Form Number: Me. I-15

Explains how employee leasing is affected under the Maine Employment Security Law.

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Table of Seasonal Industries (Me. FX-33)

Form Number: Me. FX-33

A list of seasonal industries and their dates of business.

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Seasonal Industries and Unemployment Benefits (Me. I-17)

Form Number: ME I-17

How seasonal industries affect eligiblity for Unemployment Benefits.

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Localization of Work Rules (Me. I-36)

Form Number: ME I-36

Provides information on determine if an employer's workers are covered for Unemployment Insurance.

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Request for Employer Experience Rate

Form Number: Me. TAX-80

This request form is to be used by a Payroll Processor only. A tape provided by the payroll processor in the format listed retrieves information specific to an employer and their appropriate tax rate, competitive skills training fund rate, seasonality and account status are issued to the payroll provider.

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Authorization to Correct Wages (Starting in 2008 and thereafter)

Form Number: ME C-1A (CSSF)

Starting in 2008 and thereafter, this form is used to correct wages previously filed and apply for a refund of the overpayment or to pay the additional tax due.

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Employer's Multi-Quarter Contribution & Payroll Report (Non-Seasonal)

Form Number: ME C-2.6NS

This form allows employers to send wage information for multiple quarters.

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Professional Employer Organizations (Leasing Companies) (Me. I-16)

Form Number: Me. I-16

This is information for Professional Employer Organizations (PEOs) and their clients to inform each of the PEO's responsibilities regarding UI reporting requirements in Maine.

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Readjustment Assistance Act (Brochure A)

Form Number: TRA-17A

Explanation of benefits and allowances available for Trade Readjustment Allowances and the Trade Adjustment Assistance Programs. (For Trade Certifications Numbered 50,000 - 69,999 or 80,000+)

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Readjustment Assistance Act (Brochure B)

Form Number: TRA-17B

Explanation of benefits and allowances available for Trade Readjustment Allowances and the Trade Adjustment Assistance Programs. (For Trade Certifications Numbered 70,000)

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Dependents Claim Form - Continuation Sheet

Form Number: B-70.1

Continuation sheet for listing additional dependent children when using the Form Me. B-70

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Doctor's Statement

Form Number: BD-4.7 (Web)

This form can be used when medical information is required in order to process a claim for unemployment compensation.

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How to Prepare for an Appeal Hearing (Me. A-12)

Form Number:

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Employers Status Report: For Subject Employee Leasing Clients

Form Number: ME FX-1L

As a Client of an Employee Leasing Company, you are required to complete this form.

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Frequently Asked Questions about Trade Benefits

Form Number: N/A

Workers who lose their jobs or have their hours or wages reduced because of foreign trade may be eligible for trade benefits under the Trade Adjustment Assistance (TAA), Alternate Trade Adjustment Assistance (ATAA), and Trade Readjustment Allowances programs.

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Tax Form C-24.1 Surety Bond Agreement (non-cash)

Form Number: C-24.1

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Tax Form C-24.2 Cash Surety Agreement

Form Number: C-24.2

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Tax Form C-24.3 Cash Asset Addendum

Form Number: C-24.3

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Tax Form C-24.4 Letter of Credit Agreement

Form Number: C-24.4

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Application to Join Group Account

Form Number: C-24.7

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ReEmployME File Formatting Specifications for Electronic Transmittal of Quarterly Unemployment Contributions and Wage Reporting.

Form Number: N/A

This document contains information on the file format that is accepted by the Maine Department of Labor for electronic submission of quarterly returns.

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ReEmployME System Guide: Employer Portal Account

Form Number:

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Employer's Guide to Maine Unemployment Laws I-47

Form Number:

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