- Home to DLR
- Home to Reemployment Assistance
- Advisory Council
- Forms
- Services for Individuals
- Services for Businesses
- Employer Menu
- Register Your Business
- File a Quarterly Report
- Report New Hires
- Filing Instructions for Bulk Claims
- State Information Data Exchange System (SIDES) e-Response
- Forms
- Wage Reporting
- Preparing for an Audit
- Employer Handbook (Adobe PDF format)
- Frequently Asked Questions
- Field Locations
- Posting Requirement
- Employer Appeals
- Report New Hires
- Report Possible Fraud
- Equal Opportunity to Services
- South Dakota Laws & Rules
Unemployment Insurance (UI)
Forms
RA Benefits Forms
The RA Benefits forms available below are in Adobe PDF format.
Direct Deposit Form |
Medical Statement of Ability to Work |
Weekly Request for Payment |
Claimant Change of Name and Address Form Name and address may also be updated online at raclaims.sd.gov or by calling 605.626.2452. |
Employer Contacts Form (Job Search Tracking Sheet) This form also in the back of the Facts About Reemployment Assistance (PAM247) booklet |
RA Tax Forms
You can complete most RA Tax forms online, then print and mail or fax.
Register Your Business |
TWO WAYS TO REGISTERRegister your business online and receive your account number and assigned rates immediately. Complete, print and mail |
Employer's Quarterly Report/Annual Contribution and Wage Report Forms |
Online Employer’s Reemployment Assistance Quarterly Report Log in to File a Quarterly Report OR Print, complete and mail (Adobe PDF): |
Correct Information Previously Submitted (Form 21C) Excel format | PDF format (print, then complete) |
Employer’s Annual Contribution, Investment Fee and Wage Report (Form 21D and Form 21E):
Excel format | PDF Format (print, then complete) |
Additional RA Tax Forms |
Application For Designation as Seasonal Employer (Form 26) |
Application for Exemption or Transfer of Liability (Form 55) |
Domestic Employer Application to Withdraw from Annual Wage and Contribution Reporting (Form WDE) |
Domestic Employer Election to Report Quarterly Wages and Pay Contributions Annually (Form DE) |
Employer's Report on Acquiring a Business (Form 49) |
Payment Agreement (Form 10) |
Power of Attorney/Authorization of Agent (Form POA) |
Registration for State Information Data Exchange System (SIDES) E-Response (SIDES E-Response Registration Form) |
Worker Relationship Questionnaire (Form 23) |
Overpayments Forms
Credit Card Authorization Form (Adobe PDF - Print and mail or fax) |
Report Fraud (Complete online and submit or print and mail or fax) |
Appeals Forms
Complete online, then print and mail or fax.
Appeal of and Request for Hearing on Determination or Request for Waiver of Overpayment (Form UID-A1) |