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Free Michigan Uia 1538 Template in PDF

The Michigan UIA 1538 form is a crucial document for individuals seeking unemployment benefits in the state of Michigan. This form serves as a preliminary step in the claims process, helping applicants gather essential information about their employment history and personal details. By completing the UIA 1538, claimants can streamline their application, ensuring they have all necessary information at their fingertips when filing their unemployment claim.

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Structure

The Michigan UIA 1538 form plays a crucial role for individuals seeking unemployment benefits in the state. When faced with job loss or reduced hours, this form serves as a guide to help you file your claim effectively. It outlines the necessary personal information you need to provide, such as your Social Security number, mailing address, and contact details. Additionally, it prompts you to select your preferred method of payment, whether through direct deposit or a debit card. The form also requires details about your employment history, including the names and addresses of all employers you have worked for in the past 18 months, along with your earnings during that time. By gathering this information beforehand, you can streamline the filing process. Remember, this form is for your records only and should not be sent to the Unemployment Insurance office. Instead, keep it handy as you prepare to navigate the claims process, ensuring you have all the necessary details at your fingertips.

Form Example

UIA 1538

REV. 09-16

	STATE OF MICHIGAN
RICK SNYDER	DEPARTMENT OF TALENT AND ECONOMIC DEVELOPMENT	ROGER CURTIS
GOVERNOR	TALENT INVESTMENT AGENCY	DIRECTOR
	UNEMPLOYMENT INSURANCE	WANDA M. STOKES
		DIRECTOR

What You Need To File An Unemployment Claim

If you have become unemployed or your hours of work have been reduced, you may file a claim for unemployment benefits. You may file your claim by telephone toll-free at 1-866-500-0017 (TTY customers use 1-866-366-0004), or file online at http://www.michigan.gov/uia under the heading. Click on “Michigan Web Account Manager for Claimants and Employers.” Completing the information on this sheet first will save you time when you file your claim for unemployment benefits.

DO NOT SEND THIS FORM TO THE UNEMPLOYMENT INSURANCE

KEEP IT FOR YOUR RECORDS.

PERSONAL INFORMATION

Social Security Number:

Driver license number or state ID number:

Mailing address: (Where you want information about your unemployment claim sent.)

County: (Where you reside.)
Telephone number: (If you do not have a phone, give
a number where a message can be left in case UI staff
need to contact you)
Method of Payment: (You will be asked to choose	_______ Direct Deposit	______ Debit Card
whether you want your benefit payment issued by
direct deposit to your bank or credit union account or	_______ Routing Number	______ Bank Account
by debit card.)
If you are not a citizen or national of the United States,
give your Alien Registration Number and the expiration
date shown on your alien ID or documents:

You will need the names and payroll addresses for all the employers you have worked for in the 18 months prior to filing your claim. You may be asked to provide the UI with some of the information contained on this form. It would also be helpful to have available any W-2 forms you have received from employers you have worked for in the past 18 months as the form contains the employer’s Federal Employer Identification Number (FEIN).

EMPLOYMENT INFORMATION

	Your Most Recent Employer #1:
	(Your separating employer)
	Street Address: Use the payroll address if known.

	City, State and Zip Code:

	Dates of employment and earnings: (Report your	Beginning Date: ______________________
	gross earnings for your most recent period of	Ending Date: _________________________
	continuous employment with this employer.)	Earnings: ____________________________

UIA 1538 (Rev. 09-16)

List all other employers you have worked for in the past 18 months giving the payroll address if known (use additional paper if necessary):

EMPLOYER #2

		Your Most Recent Employer #2:

		Street Address: (Use payroll if known.)

		City, State and Zip Code:

		Dates of employment and earnings: (Report your	Beginning Date: ____________________
		gross earnings for your most recent period of	Ending Date: _______________________
		continuous employment with this employer.)	Earnings: __________________________

EMPLOYER #3

		Your Most Recent Employer #3:

		Street Address: (Use payroll if known.)

		City, State and Zip Code:

		Dates of employment and earnings: (Report your	Beginning Date: ____________________
		gross earnings for your most recent period of	Ending Date: _______________________
		continuous employment with this employer.)	Earnings: __________________________

DATES

When entering dates, either on the web or the telephone, you must enter two digits for the month, two digits for the day, and four digits for the year. Example: May 19, 2016 should be entered as 05/19/2016 on the web or 05192016 on the phone.

WAGES

Your benefit entitlement will be based on gross wages paid in the first four of the last five completed calendar quarters immediately preceding the Sunday of the week in which you file your claim. If there are insufficient wages in those quarters, the wages in the last four completed quarters will be used. For example, if you filed for benefits on Wednesday, April 12, 2017 the wages paid during the calendar four of the five quarters below would be used to compute your benefit entitlement.

January 1, 2017 through March 31, 2017

October 1, 2016 through December 31, 2016

July 1, 2016 through September 30, 2016

April 1, 2016 through June 30, 2016

January 1, 2015 through March 31, 2016

You may be asked to provide quarterly wages if they were not reported by your employer(s). You should have the information available before filing your claim.

If you have any questions about this form, call the Inquiry Line at 1-866-500-0017. TTY customers call 1-866-366-0004.

TED is an equal opportunity employer/program.

▼ Michigan Uia 1538 PDF Form

Document Specs

Fact Name	Detail
Form Title	UIA 1538 REV. 09-16
Governing Law	Michigan Employment Security Act (MCL 421.1 et seq.)
Purpose	This form is used to file a claim for unemployment benefits in Michigan.
Filing Methods	Claims can be filed by telephone at 1-866-500-0017 or online at http://www.michigan.gov/uia.
Personal Information Required	Claimants must provide their Social Security Number, driver license or state ID number, and mailing address.
Employment History	Claimants need to list all employers from the past 18 months, including payroll addresses and earnings.
Benefit Calculation	Benefits are based on gross wages from the first four of the last five completed calendar quarters before filing.

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