Forms - NonProfits
UC-1681:
Surety Bond [Size=30k]
This form is a contract/bond between a reimbursable employer's insurer and the Department of Labor and Industry. It serves as collateral in the event UC benefit charges are unpaid and will be liquidated up to the stated amount of the contract/bond.
You must also complete Form UC-1692, which is used to determine the amount of the contract/bond.
UC-1692:
Election Or Re-election Of Reimbursement [Size=425k]
This form is the agreement an employer must complete to elect reimbursable coverage.
Completed forms should be mailed through USPS to:
Department of Labor & Industry
Office of UC Tax Services
PO Box 68568
Harrisburg, PA 17106-8568
If mailing through UPS/FedEx, please mail to:
Office of UC Tax Services
651 Boas St FL 9
Harrisburg PA 17121-0751