Unemployment Insurance Act 63 of 2001 - Employers Declaration of Employees - for the month of

Oct 3, 2026

Uploaded by Ben

Employers Declaration of Employees for a specific month under the Unemployment Insurance Act (Act 63 of 2001). The form collects employer details, employee identity and employment dates, remuneration and total gross remuneration per month, and total hours worked during the month. It also records the reason for termination using provided codes and indicates contributor or non-contributor status, including reasons and compliance with submission requirements to the UIF by the seventh day of each month.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Employers Declaration of Employees for the month of

1. Employer Details

2. Employee Details

Reason for Termination Codes

UNEMPLOYMENT INSURANCE ACT63 OF 2001 # Employers Declaration of Employees for the month of information to be supplied in terms of Section 56(1&3)read with Regulation 13(1&2) ## 1.EMPLOYER DETAILS 1 1.1 UIF Employer Reference No ①1.3 Trading name of business 1.5 Address where employees listed in Item 2 work(if different to the address in 1.4) 1.8 E-mail address 1.9 Fax No ## 2.EMPLOYEE DETAILS I, (Name of Employer),ID No understand that it is an offence to make a false statement. EMPLOYER SIGNATURE DESCRIPTIONS古★If the employer is not resident in the RSA,or is a body corporate not registered in the RSA,an authorised person must carryout the duties of the employer in terms of this Act.D*Remuneration means remuneration as specified by the Unemployment Insurance Contributions ActIfpaid Weekly,convert remuneration to monthly salary(weekly remuneration X52/12)E*Total Hours Worked ie.Actual hours worked during the month Employers may also submit these details electronically from payrolls or on the UIF's website at www.abour.gov.za(Ufiling)Tel.no (012)3371680/1700 ①Only Applicable for Commercial Employers.For Domestic Employers provide Surname and Initials ★***Can only be determined by CCMA;Bargaining Council or Labour Court An employer must by the seventh day of each month provide the Commissioner with all the information for the previous month regarding the employer's contact details or employeesremuneraio details icluding new appointmensan teminaionof service.The employer must forwar tis fom to the Unemploymen nsurance Fund at(12)337-194344 or337-1580/81/82 or subit same at any branch of the UF which is ls to the employer The completed form can also be faxed to anyof th following numbrs:Pa(12)3095142/5286;Jhb(011)4973293;Dbn(031)3662156;Polokwane(015)2901670;Mmabatho(018)3842658;East Ldn(043)7013263;Biftn (051)4479353;CT(021)4418024;Wtb(013)6560233;PE(041)5861541;Gmn(011)8732219;George(044)8732568;Pmb(033)3945069. 1.2 PAYE Reference No (If registered with SARS) 1.4 Physical Address 1.6 Postal address 1.7 Co.Reg.No(CIPRO N 1.10 Phone No | A
Surname | B
Initials | C
ID Number
(13 Digit bar-coded RSA ID No) | | | | | | | | | | | | | D*
Total(Gross)
Remuneration paid
to Employee Per
Month | | E*
Total
Hours
Worked
during
Month | F
Commencement date of
Employment | | | | | | G
Termination Date | | | | | | H
Reason for
Termination
(Use
Termination
Codes as
supplied at the
bottom of the
page) | I
Indicate
whether
contributor
or non-
contributor
(YES OR
NO) | J**
If non-
Contributor
state reason
(Use codes at
bottom of
page) | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | | | | | | | | | | | | | | | | R | c | | D | D | M | M | Y | Y | D | D | M | M | Y | Y | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | ,declare that the above information is true and correct.I REASON FOR

FAQs

What information must an employer provide for the previous month under this declaration?

The employer must submit employer contact details and employee remuneration details (including new appointments and service terminations) for the previous month to the UIF/Commissioner as required.

How is weekly remuneration converted to monthly remuneration?

If remuneration is paid weekly, convert it to monthly salary using weekly remuneration multiplied by 52 and divided by 12.

What does the form require regarding termination and non-contribution status?

The employer must record the reason for termination using the termination codes provided, and indicate whether each employee is a contributor or non-contributor; if non-contributor, provide the stated reason using the relevant codes.

Oct 3, 2026

Uploaded by Ben