Form UI-41 and UI-41a (Computer Generated)
Forms UI-41
and UI-41a, Supplemental Report of Service or Compensation, are
used to obtain reports of compensation at a higher maximum than reported on your
annual report. This information may allow your employee to receive additional
Unemployment Insurance (UI) or Sickness Insurance (SI) benefits. This form is
accepted as valid certification of service and compensation provided it is
signed by the contact official or a designee.
The forms are is designed to obtain service and compensation information
needed to determine eligibility for benefits under the RUIA. Complete the
information for each item checked as follows:
|