Employer Service and Compensation Reports

OMB 3220-0070

The reports obtain the employee's service and compensation for a period subsequent to those already on file and the employee's base year compensation. The information is used to determine the entitlement to and the amount of benefits payable.

The latest form for Employer Service and Compensation Reports expires 2023-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form UI-41 (08-17) Employer Service and Compensation Reports Form
3220-0070.docx Supporting Statement A
Employer Service and Compensation Reports Form

All Historical Document Collections

202301-3220-002 Approved without change	Extension without change of a currently approved collection	2023-01-27
201912-3220-004 Approved without change	Revision of a currently approved collection	2019-12-23
201608-3220-002 Approved without change	Extension without change of a currently approved collection	2016-10-26
201309-3220-001 Approved without change	Extension without change of a currently approved collection	2013-09-27
201008-3220-001 Approved without change	Extension without change of a currently approved collection	2010-08-25
200705-3220-002 Approved without change	Extension without change of a currently approved collection	2007-06-25
200406-3220-004 Approved without change	Extension without change of a currently approved collection	2004-06-25
200108-3220-001 Approved without change	Revision of a currently approved collection	2001-08-03
199807-3220-003 Approved without change	Revision of a currently approved collection	1998-07-13
199506-3220-009 Approved without change	Extension without change of a currently approved collection	1995-06-30
199209-3220-001 Approved without change	Revision of a currently approved collection	1992-09-02
198905-3220-007 Approved without change	Revision of a currently approved collection	1989-05-26
198602-3220-002 Approved without change	Extension without change of a currently approved collection	1986-02-03
198302-3220-002 Approved without change	Revision of a currently approved collection	1983-02-16
198105-3220-037 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-05-29
198005-3220-004 Approved without change	Extension without change of a currently approved collection	1980-05-28
197904-3220-005 Approved without change	Extension without change of a currently approved collection	1979-04-27
197903-3220-007 Approved without change	Extension without change of a currently approved collection	1979-03-14
197803-3220-012 Approved without change	Extension without change of a currently approved collection	1978-03-31
197803-3220-011 Approved without change	Extension without change of a currently approved collection	1978-03-06