ࡱ> q` bjbjqPqP 5b::```tCCCC4C tYLDbDbDbDbDAEAEAE.Y0Y0Y0Y0Y0Y0Y$Zh ]JTY`JF=EAEJFJFTYbDbDiYGGGJFR8bD`bD.YGJF.YGGJH`JbD@D uCFLJJdY0YJW^FW^JW^`J AE0qE"GEEAEAEAETYTYGAEAEAEYJFJFJFJFttt;CtttCttt UNEMPLOYMENT INSURANCE ACT 63 OF 2001UI-19 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)FAX NO (012)337-1943/1944/1580/1581/1582An employer must by the seventh day of each month inform the Commissioner of any changes arising during the previous month regarding the employer's contact details or employees remuneration details including new appointments and termination of service. The employer must forward this form to the UIF, PRETORIA, 0052 or alternatively to any branch of the UIF which is closest to the employer. The completed form can also be faxed to any of the above numbers. 1. EMPLOYER DETAILS 1.1 UIF Employer Reference No /Branch No1.2 PAYE Reference No (If registered with SARS)(1.3 Trading name of business1.4 Physical Address1.5 Address where employees listed in Item 2 work (if different to the address in 1.4)1.6 Postal address ___________________________________________________________1.7 Co. Reg.No(CIPRO No)1.8 E-mail address 1.9 Fax No1.10 Phone No 1.11Authorised person**2. EMPLOYEE DETAILS A SurnameB InitialsC ID Number (13 Digit bar-coded RSA ID No./Passport No) D* Total (Gross) Remuneration paid to Employee Per MonthE* Total Hours Worked during MonthF Commencement date of Employment G Termination DateH 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)RcDDMMYYDDMMYYI, ___________________________________ (Name of Employer), ID No ______________________, declare that the above information is true and correct. I understand that it is an offence to make a false statement. EMPLOYER SIGNATURE ___________________________________________________ DATE ________________________ DESCRIPTIONS Code(J) Reason for Non-Contribution *****If the employer is not resident in the RSA, or is a body corporate not registered in the RSA, an authorised person must carry 1Temporary employees (less that 24 hours per month)out the duties of the employer in terms of this Act.2Learners in terms of the Skills Development ActD*Remuneration means actual basic salary plus payment in kind (Declare actual gross salary)3Employees in the National and Provincial spheres of GovernmentIf paid Weekly, convert wages to monthly salary (weekly wages X 52/12)4Employees who are repatriated at the end of their contract of serviceE*Total Hours Worked ie. 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