Fillable WZ Account No. Employer (ADP)

Fill Online, Printable, Fillable, Blank WZ Account No. Employer (ADP) Form

Use Fill to complete blank online ADP pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

WZ Account No. Employer (ADP)

On average this form takes 8 minutes to complete

The WZ Account No. Employer (ADP) form is 2 pages long and contains:

  • 0 signatures
  • 5 check-boxes
  • 30 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your ADP forms online.

BROWSE ADP FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Account No.
Name of Employer
By
Title
Date
Employer
located at
(Street Address, City, State, Zip Code) Telephone Number
Telephone Number(Street Address, City, State, Zip Code)
)(
WŽǁĞƌŽĨƚƚŽƌŶĞLJĨŽƌZĞƉƌĞƐĞŶƚŝŶŐŵƉůŽLJĞƌ
ƵŶĚĞƌƚŚĞ/ůůŝŶŽŝƐhŶĞŵƉůŽLJŵĞŶƚ/ŶƐƵƌĂŶĐĞĐƚ
( )
LE-10 (Rev. /1)
E-mail Address
located at
hereby authorizes
E-mail Address
to represent the Employer before the Director in any and all matters, to act in the Employer’s stead with the same
consequences as the Employer, and to receive any and all information requested by said Representative pertaining to the
Employer’s liability for the payment of contributions, interest and penalties under the Illinois Unemployment Insurance Act
(except that I understand that notices pertaining to a Determination and Assessment or Refund/Adjustment shall be sent to
the employing unit at its principal place of business or its last known place of business or residence), until such time as the
appointment is terminated. I understand that my Representative shall be provided information only to the extent that it is
requested for one of the purposes set forth in Section 1900 of the Illinois Unemployment Insurance Act [820 ILCS
405/1900].
Signature
&Ădž͗ϮϭϳͲϱϱϳͲϭϵϰϴ
ϯϯ^ŽƵƚŚ^ƚĂƚĞ^ƚƌĞĞƚ͕ŚŝĐĂŐŽ/>ϲϬϲϬϯͲϮϴϬϮ
Clear Form
PRINT
SAVE
ADP, LLC and its subsidiaries and Corporate Cost Control, LLC.
Known as ADP Unemployment Claims. Service Bureau: ADPCCC 001.
PO BOX 1390, LONDONDERRY NH 03053-1390
855
537-8499
uidocs@adpunemploymentclaims.com
UI-1M (Rev. 9/1)
33 SOUTH STATE STREET CHICAGO, IL 60603-2802
UNEMPLOYMENT INSURANCE SPECIAL MAILING FORM
Signed by
Title
Date
Telephone Number
The purpose of this form is to notify the Department of a request to have correspondence sent to an address
other than your business address or to terminate a preexisting address, except that notices pertaining to a
Determination and Assessment or Refund/Adjustment shall be sent to the employing unit at its principal place
of business or its last known place of business or residence. If the requested address being added is for a
third party or service bureau, you must also complete the Power of Attorney (LE-10) form.
Employer Name
DBA Name
Illinois UI Account Number
Federal I.D. Number
Note: Each form can be directed to only one address. Therefore, check only once for each form. If your
request cannot be contained in its entirety on this form because of multiple addresses, please provide
additional copies
of the form:
BIS-32 (Notice to Chargeable Employer)
UI-3/40 (Contribution & Wage Report)
Ben-118/118R Benefit Charge Notice
UI-5A/UI5B (Rate Notice)
Benefit Appeal Notice
SI-5 (Notice of Benefit Earnings Audit)
BIS-32 (Notice to Chargeable Employer)
UI-3/40 (Contribution & Wage Report)
Ben-118/118R Benefit Charge Notice
UI-5A/UI5B (Rate Notice)
Benefit Appeal Notice
SI-5 (Notice of Benefit Earnings Audit)
C/O (Name of Representative or Service Bureau)
Street Address Unit or Suite
City, State, ZIP
E-Mail Address
Termination DateEffective Date
Termination Date
E-Mail Address
Country Telephone Number
Street Address Unit or Suite
C/O (Name of Representative or Service Bureau)
Effective Date
City, State, ZIP
Country Telephone Number
&Ădž͗ϮϭϳͲϱϱϳͲϭϵϰϴ
X
X
X
X
X
PO BOX 1390
USA
855-537-8499
uidocs@adpunemploymentclaims.com
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

WZ Account No. Employer (ADP)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 8 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document