Forms

Employers

LIR#27
Application for Certificate of Compliance with Section 3-122-112, HAR (Use this form to request a tax clearance from the Department of Labor & Industrial Relations for Professional Service Awards)

BB-1
Basic Business Application (Use this form to register your business with the Unemployment Insurance Division when employment commences)

*UC-B6
Quarterly Wage, Contribution and Employment and Training Assessment Report
(*Not available online – for assistance, please call 586-8915 or 586-8916)

UC-25
Notification of Changes (Use this form to notify the Unemployment Insurance Division of any changes to an employer’s address or status of business)

UC-336
Election By Family Owned Corporation to be Excluded from coverage Under Section 383-7(20), HRS (Use this form to elect exclusion from unemployment insurance coverage of a family-owned corporation)

UC-347
Notification of Acquisitions or Transfers (Use this form to report acquisitions or transfers in accordance with Section 383-66(b), HRS, if there is substantially common ownership, management or control between employing units or an acquisition or transfer made between an employing unit and a person who is not an employing unit.  The department will determine substantially common ownership, management or control.  All parties involved in the acquisition or transfer must file the form separately.

UC-86
Waiver of Employer’s Experience Record (Use this form to request acquisition of the experience record of a predecessor employer)

Self-Financing for Non-Profit Organizations (NPO)
Non-profit organizations (religious, charitable, and educations) qualifying for income tax exemption under the Section 501(c)(3) Internal Revenue Code may apply for exemption from paying contributions by requesting self-financing status under provisions of Chapter 383-62(d) of the Hawaii Employment Security Law.  Indian tribes or tribal units may elect to be self-financing.
For more information click here:
New Liable Employer - UC175 Application for Self-Financing
Converting from a Contributory Employer to a Self-Financing Employer - UC175 Application for Self-Financing

UI Claimants

UC-156
Claimant’s Election to Withhold Federal/State Income Tax  (Use this form to elect to have Federal and State taxes withheld.  Unemployment Insurance benefits, including Emergency Unemployment Compensation and Federal Additional Compensation are taxable income.  If you elect withholding, you are permitted only one change during your benefit year to stop withholding)

UC-161(a)
Instructions for Partial and Part-Total Claimant’s Filing on the Web
In addition of filing your weekly or biweekly claim certification, your employer must file “Weekly Report of Low Earnings” to verify your earnings, availability for work and continued employment for each week that you claim.

UC-226
Verification of Registration for Work  (You must register for work within 7 calendar days after the date you were advised to register by posting a resume online in HireNet.  You must take this form to WDD or a One-Stop office listed on the back to have Part A completed for verification of your registration for work and to have this form returned to your local unemployment office. If you will be referred to your next job by your union hiring hall, report to your union hall within 7 calendar days after filing your claim and have the union complete Part B of this form. Return the completed form to your unemployment office)

UC-253
Record of Contacts Made for Work

UC-275
Request for Withdrawal of Claim

UC-348
Partial Unemployment Information (Information for claimants and employers on the definition, assessment and determination of partial unemployment. Also, includes the “Verification of Partial Unemployment Status” form for employers to compete and return to confirm their employee’s partial unemployment status. This form is due within 5 working days from the date the application is filed.)