UI 3/40 Employer’s Contribution and Wage Reporting
To submit quarterly Contribution and Wage Reports for 2021:
Log on t
o the MyTax Illinois website at http://mytax.illinois.gov
to establish your UI account, file your reports, and
make payments, all electronically. This is preferred!
Other features available on MyTax Illinois:
Request refunds online
View your new annual tax rates
View your tax letters and correspondence
Request interest and penalty waivers
Request interest and penalty waivers
Maintain Power of Attorney relationships
and much more…
Or, comp
lete and sign the interactive PDF form, and then PRINT and MAIL.
Don’t forget to fill in your 7-digit UI Account number and your 9-digit FEIN number.
Visit our IDES Employer Update website, at www2.illinois.gov/ides/employers/MyTaxUIRates for additional
information. Contact the IDES Employer hotline at 1-800-247-4984 if you have any questions about MyTax Illinois
or the UI 3/40 form.
The UI 3/40 Form starts on the next page.
Revised: October 2021
Page 1 of 3
11.
Total Wages
I hereby certify that the information contained in
this report and in all accompanying schedules is
true and correct to the best of my knowledge and
belief; and that no part of the contribution reported
was or is to be deducted from workers’ wages.
Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
This report MUST be signed by owner, partner,
officer or authorized agent within the employing
enterprise. If signed by any other person, a Power
of Attorney must be on file. (See Instructions)
( )
EMPLOYER’S CONTRIBUTION AND WAGE REPORT
STATE OF ILLINOIS Department of Employment Security
FORM UI-3/40 Rev. 10/2021 CONTRIBUTION RATE FOR
PENALTY ($50.00 MIN.) INTEREST DUE
DUE AFTER ABOVE DATE AFTER ABOVE DATE
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Employers
that have less than 25 employees have the option of using
this form. If the employer has 25 or more employees, the employer
must file electronically.
Page No. 1 of_____Pages
Do NOT include wage corrections
for a prior quarter in this report.
This agency is requesting both disclosure of
information and payment of contributions that
are necessary to accomplish the statutory
purpose as outlined under 820 ILCS 405/100-
3200. Disclosure of information and payment
of contributions are REQUIRED. Failure to
provide information or pay contributions may
result in this form not being processed and
may result in statutorily prescribed sanctions,
including penalties and/or interest.
L09ZZZZZZZ
AREA
CODE
9999999 20062 L10ZZ-2006
ILLINOIS
ACCOUNT NUMBER YR/QTR PERIOD ENDING
Do NOT staple reports or payment.
$. . . . . . . . . . . . . . . . . . . . . . . . . .
F
9. NAME OF WORKER 10. TOTAL Wages Paid
(First, initial, then last)
(Type or Print)
(Include Wages in
Excess of $12,960
000 : 00 : 0000
Enter Dollars & Cents:
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Your Federal Employer Identification Number
(If not shown or if incorrect enter correct number)
CHANGE IN STATUS If a change has occurred in the status of your business, complete form UI-50A.
Check this box to indicate that you no longer have workers in Illinois and want your account terminated.
Also, complete form UI-50A.
1. ENTER THE TOTAL NUMBER OF COVERED WORKERS (full and part time) who performed services
during or received pay for the payroll period including the 12th of each month of the quarter.
If none, enter “0”.
1ST MONTH________________2ND MONTH_________________3RD MONTH______________
2. TOTAL WAGES PAID for covered employment
(If no wages were paid, see instructions.)
IMPORTANT — SEE INSTRUCTIONS
3.
LESS: Wages in excess of $12,960 per covered worker per calendar year.
4. TAXABLE WAGES (line 2 minus line 3)
5A. If the quarter’s TOTAL WAGES (Line 2) are less than $50,000,
calculate at the lessor of your rate as shown on your "Annual Contribution
Rate Determination" or 5.4%.
Use this space if TOTAL WAGES (Line 2) are $50,000 or more this quarter.
5B. CONTRIBUTION DUE - Multiply line 4 by your rate.
6A. Add: Interest at 2% (.02) per month for late payment
6B. Add: Penalty for late filing ($50.00 minimum)
6C. Add: Previous Underpayment PLUS interest
6D. Deduct: Previous Overpayment
7. TOTAL PAYMENT DUE
MAKE CHECK PAYABLE TO:
“ILLINOIS DIRECTOR OF EMPLOYMENT SECURITY”
(If less than $2.00 - Send report only)
This report & payment can be mailed to: IDES, PO Box 19300, Springfield, IL 62794-9300
8. Worker’s Last 4 numbers of Social
Security Number
00/0
00-0000000
0.00
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MyTax Illinois - You may file your quarterly report and make your payment through the
internet using the MyTax Illinois application, which will calculate your taxable wages and
contribution due. If you are a tax preparer, this form does not contain a PIN for your
client. Instructions for using Illinois MyTax Illinois to assist your clients are provided
on the IDES website.
GENERAL INSTRUCTIONS
Filing Reports - The Employer’s Contribution and Wage Report, IDES Form UI-3/40, must be filed
quarterly by each employer subject to the Illinois Unemployment Insurance Act.
The original report must be filed, and the contribution payment made,
no later than the last day of the month following the end of the quarter;
April 30, July 31, October 31 and January 31. Reports and remittances
personally delivered or postmarked after that date will be subject to
penalty and/or interest.
An employer who paid no wages during a quarter, but has not
permanently ceased being an employer, must file a report showing
“No Wages Paid This Quarter”. An employer contesting liability for
the payment of contributions should write “Liability Protested” and give
the reason on the report after completing all items and signing the report.
Nonprofit organizations and local government entities which elected to make payments in lieu
of contributions must file the contribution and wage report (UI-3/40) quarterly even though
contributions are not required.
Adjustments
-
Make no adjustments for prior quarters on the current quarter’s report.
Request the proper form from the Employer Hot Line Section, Revenue
Division, 33 South State Street, Chicago, Illinois 60603. For more information,
please visit the "Contact IDES" page on the IDES website. Reporting errors
should be corrected even if the contribution for the quarter remains unchanged.
Supplemental Report
- Should be filed whenever there are underreported and/or omitted
wages for a quarter. Please note on the report whether it is a
Supplemental or Amended Report.
LINE ITEM INSTRUCTIONS FOR PREPARATION OF UI-3/40 REPORT
Change in Status - Check this box to indicate that you no longer have workers in Illinois
and want your account terminated. For a change in status, a change
in business address or if you no longer have workers in Illinois, please
complete form UI-50A. If you want some of your correspondence to be
mailed to a special address, please complete the “Special Mailing” form
UI-1M. These forms can be obtained at our website which is
www.ides.illinois.gov and should be attached to your report.
Line 1. No. of Covered Workers - Enter the total number of covered workers (full and part
time) who performed services during or received pay for
the payroll period including the 12th of each month of
the quarter. Include workers who have earned more than
$12,960 in the calendar year and those on vacation or paid
sick leave. Exclude workers on strike.
Line 2.
Total Wages Paid - Enter all wages paid in the quarter for covered employment
including wages paid to workers who have already received wages in
excess of $12,960 during the calendar year. Wages include (a)
salaries, commissions and bonuses; tips reported to the
employer; separation pay, vacation pay, prizes, sick pay,
payments on account of retirement; (b) the reasonable cash
value of remuneration paid other than cash, such as goods,
meals and lodging, and (c) any remuneration for services
performed within the State which is considered wages under
the Federal Unemployment Tax Act.
NOTE: An employer who paid no wages during a quarter, but has not
permanently ceased being an employer, must file a report showing
“No Wages Paid This Quarter”.
Line 3. Less Wages in Excess of $12,960 - Enter wages included in line 2 in excess of
the $12,960 taxable for each worker. Do not
include excess wages of prior quarters.
Line 4. Taxable Wages - Deduct Line 3 from Line 2 and enter the net amount on this line.
Line 5A and 5B - Complete only one, whichever is applicable.
5A - If the quarter’s total wages are less than $50,000, calculate at the
lessor of your rate as shown on your "Annual Contribution Rate
Determination" or 5.4%.
5B - If the quarter’s total wages are $50,000 or more, calculate at the
rate shown on your "Annual Contribution Rate Determination".
Line 6A. Interest - On contributions not paid by the interest due date, add interest at the
rate of 2% per month computed at 12/365 of 2% per day. Payments
received more than 30 days after the due date are deemed to have
been received on the last day of the month preceding the month in
which the payment was received. (Exception: For the first thirty days
past the due date, interest is computed on a daily basis.)
Line 6B.
Penalty - On reports filed after the penalty date, the penalty is $5 for each $10,000
or fraction thereof of total wages or $2,500 per month, whichever is
less. The maximum penalty is $10 for each $10,000 or fraction thereof
of total wages or $5,000, whichever is less. THE PENALTY FOR LATE
FILING CAN IN NO INSTANCE BE LESS THAN $50.
Line 6C.
Previous Underpayment - If payment for any previous underpayment is included
with the remittance for this report, enter the amount of
the underpayment including interest.
Line 6D.
Previous Overpayment - Credit shown on this line may be deducted from the
contribution due this quarter.
Line 7.
Total Payment Due - Enter the sum of line 5A or 5B plus Lines 6A, 6B, and 6C less
any amount on line 6D.
Signature - This report must be signed by owner, partner, officer or authorized agent within
the employing enterprise. If signed by any other person, a Power of Attorney
must be on file.
Column 8. Worker’s Last 4 of SS Number - Show the last 4 of the Social Security
Number of each worker.
Column 9.
Name of Workers - Type or print the workers’ names.
Column 10.
Total Wages Paid - Enter total wages paid to each worker during the quarter
regardless of when services were performed. Total wages
include both taxable and non-taxable wages paid in excess of
$12,960.
Line 11. Total Wages for this Quarter – Enter the total wages reported in Column 10.
For historical Illinois UI Tax Rates – To obtain a Historical Table, use the
following link: http://www2.illinois.gov/ides/employers/UITaxRates