UITL-18 (R 12/2014)
Colorado Department of Labor and Employment, Division of Unemployment Insurance, P.O. Box 8789, Denver, CO 80201-8789
303-318-9100 (Denver-metro area) or 1-800-480-8299 (outside Denver-metro area)
INSTRUCTIONS FOR COMPLETING THE POWER OF ATTORNEY
Emp
loyer Information
Employer Name: Type or print legibly the entity name or business name.
Trade Name: Type or print legibly the doing-business-as name or trade name.
Employer Account Number: Type the 9-digit Colorado unemployment insurance (UI) premium account number. The power of attorney will not be
processed or approved if this account number is not provided.
Business Location Address Only (No PO Boxes): Type the entity’s or business's physical location address.
Acceptance of New Power of Attorney
Effective Date of
Acceptance: Complete this section if you want to name or change an entity or individual to have power of attorney. If you complete
this section, you must provide an effective date.
SIDES: State Information Data Exchange System. By participating in this system, you will receive and respond to the electronic version of form UIB-
290, Colorado’s Request For Facts About A Former Employee’s Employment. To find out more information about SIDES go to http://info.uisides.org. It
is strongly recommended that you participate in the SIDES system.
For UI premium-related information: Complete this section if you want to accept power of attorney for UI premium-related information only.
For UI benefits-related information: Complete this section if you want to accept power of attorney for UI benefit-related information only.
Power of Attorney Complete Name and Address: Type the name and address of the entity or individual you want to accept as the power of attorney.
Do not list an individual’s name unless that is the business name.
NOTE: If you have an existing power of attorney and the UI Division approves your acceptance of a new power of attorney, the new power of attorney
automatically replaces the existing power of attorney for the purposes you indicate on this form.
Mailing-Address Information
Complete Mailing Address: For UI premium information and/or forms such as the UITR-7, Unemployment Insurance Rate Notice; UITR-1, Your
Quarterly Report of Wages Paid and Premiums Owed; UITR-1a, Unemployment Insurance Report of Workers Wages; and UITR-2, Unemployment
Insurance Statement of Payment Due; or any other premium forms you must provide the complete mailing address regardless of whether you are adding or
changing a power of attorney. This information must be completed to ensure that UI correspondence is sent to the address of the entity or individual who
will be responsible for UI correspondence. Provide a second mailing address only if you want the UI benefits-related information sent to a mailing address
different from the mailing address used for premium-related information.
NOTE: You are responsible for ensuring that any UI correspondence that is sent to an incorrect mailing address is properly forwarded. You are also
responsible for updating your mailing address with us.
Power-of-Attorn
ey Signature
New Power of Attorney Representative Signature: A representative of the entity or the individual who you want to accept as the power of attorney
must provide his or her name and title and sign and date the form in order to make this a valid document.
Employer Approval
Signature of Employ
er Official: The employer must sign this form to accept an entity or individual as the power of attorney. The employer official’s
name, title, signature, and date of signature are required to make this a valid document.
Discontinuation of Power of Attorney
If you elect to discontinue a power of attorney without accepting a new power of attorney, submit a written request to the UI Division at the above address.
