Unemployment Quote Submittal

Unemployment Quote Submittal
Member Name (SU/SD):
Applicant Name:
Applicant Title:
Applicant Phone #:
Please enter a valid phone numberFormat: (000) 000-0000.
Applicant Email:
example@example.com
There are two components needed to obtain a quote.

Please forward any additional documentation (if available).
Estimated taxable wages for the year you wish to join.
This is defined as the first $8,000 in wages per employee (not FTE).
Do you have three complete fiscal years as well as the current year claims activity from the Vermont Department of Labor?
Please upload the information here.

Cancelof
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: