Marcia Hultman

Cabinet Secretary

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Unemployment Insurance

Forms

The forms available below are in Adobe PDF format unless otherwise noted.

UI Benefits Forms

Direct Deposit Form
Medical Statement of Ability to Work
Weekly Certification
The following forms can also be found in the back of the Facts About Unemployment Insurance (PAM247) booklet:
Claimant Change of Name and Address Form
Name and address may also be updated online at www.sd.uiclaims.com or by calling 605.626.3179.

Employer Contacts Form

 

UI Tax Forms

The UI Tax forms available below are in Adobe PDF format and can be completed online unless otherwise noted.

Form 1 Employer's Report to Determine Liability

Form 1NP

Employer’s Report to Determine Liability for 501c3 Non Profit Employers
Form 1PS Registration Report to Determine Liability for Political Subdivisions
Form 10 Payment Agreement
Form 21 (Excel format)
Employer's Quarterly Contribution, Investment Fee and Wage Report
Form 21 (print, then complete)
Form 21C (Excel format) Statement to Correct Information Previously Submitted
Form 21C (print, then complete)
Form 21D & E (Excel format) Employer’s Annual Contribution, Investment Fee and Wage Report
Form 21D & E (print, then complete)
Form 23 Worker Relationship Questionnaire
Form 26 Application For Designation as Seasonal Employer
Form 49 Employers Report on Acquiring a Business
Form 55 Application for Exemption or Transfer of Liability
Form DE Domestic Employer Election to Report Quarterly Wages and Pay Contributions Annually
Form POA Power of Attorney/Authorization of Agent
Form WDE Domestic Employer Application to Withdraw from Annual Wage and Contribution Reporting
SIDES E-Response Registration Form Registration for State Information Data Exchange System (SIDES) E-Response

 

Overpayments Forms

The UI Overpayments forms available below are in Adobe PDF format and can be completed online.

Credit Card Authorization Form Form to authorize credit card or automatic payment of overpayments
Report Fraud Report suspected fraud


Appeals Forms

The UI Appeal form available below is in Adobe PDF format and can be completed online.

Form UID-A1 Appeal a UI Department Decision

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