How to Complete Michigan Form UIA-1711: Timing, Fields, and Penalty

Michigan Form UIA-1711, the Unemployment Compensation Notice to Employee, is the one-page notice every Michigan employer must give a worker at separation, regardless of whether the worker quit, was laid off, or was fired. The form carries the employer’s identifying information so the departing worker can file an unemployment claim with the Michigan Unemployment Insurance Agency (UIA). Delivery is required by Michigan Administrative Code R 421.204, and skipping it can trigger a small agency penalty.¹

When You Have to Hand It Over

Give the worker a completed copy at the time of separation. The reason for the separation does not change the obligation. A quit, a layoff for slow business, and a discharge for cause all get the same form on the way out.¹

R 421.204 allows two alternatives. You can deliver the form earlier in the employment relationship, such as during onboarding, and that satisfies the requirement so long as you also post adequate notices in a designated office location telling workers where to get a replacement if they lose the original. Miss the posting step and the agency can require you to go back to delivering the form individually at each separation. You can also use an equivalent written notice in place of the official UIA-1711, provided it contains all the same required information. Many larger employers build the required data into their standard separation paperwork.¹

The Four Fields To Complete

The employer section at the top of the form has four fields, and all four should be filled in before the form leaves your hands.²

UIA Employer Account Number (EAN). Your 10-digit account number assigned by the Michigan Unemployment Insurance Agency, separate from any federal tax ID. You received it when the state determined you were a liable employer during registration. If you cannot locate it, log in to your MiWAM employer account or contact the UIA.
Federal Employer Identification Number (FEIN). Your 9-digit federal tax ID from the IRS. The UIA uses it to cross-reference state records with federal wage and tax data.
Employer name and DBA. The legal business name along with any “doing business as” name, so the worker and the agency can identify the correct entity.
Mailing address. The complete address where the UIA should direct requests for wage or separation information about the departing worker. It does not have to be your headquarters; it should be the office that actually handles those inquiries.

R 421.204 specifically requires the employer’s name, account number, and address for wage and separation requests.¹ The FEIN field is not listed separately in the code, but the agency’s own form treats it as standard, so fill it in.²

The lower portion of the form is directed at the employee. It explains how to file a claim, lists the MiWAM website, and gives the UIA phone number. You do not fill in anything there. Just make sure the worker receives the whole page, not only the top half.

Where To Download the Form

The current version of UIA-1711 is available as a PDF on the Michigan Department of Labor and Economic Opportunity website, on the UIA employer forms page.² If you use an equivalent written notice in place of the official form, confirm it includes every data point listed above. An outdated printout missing a field creates unnecessary follow-up when the UIA later requests information.

Penalty for Skipping the Notice

The UIA can impose a $10 penalty against an employer that fails to deliver Form UIA-1711 or an equivalent written notice by the worker’s separation date. The penalty only applies after the agency has first notified the employer of the requirement and the employer still does not comply, so a first-time oversight without a prior warning will not automatically result in a fine. The penalty itself is appealable under the Michigan Employment Security Act.¹

The larger risk is practical rather than financial. If a former worker files a claim and reports never receiving the notice, the UIA may take a closer look at your separation records, which slows the process. A consistent policy of handing out the form at separation, or building the required information into your standard exit packet, avoids the issue.

What the Employee Does With the Form

The employer information on UIA-1711 feeds directly into the worker’s unemployment claim. The claimant files through the Michigan Web Account Manager (MiWAM) at miwam.unemployment.state.mi.us, which is available around the clock.³ During the application, the claimant enters the employer’s name, EAN, FEIN, and mailing address, so a completed form in hand prevents guesswork and speeds up filing.

If You Disagree With a Claim Against Your Account

When a former worker files against your account, the UIA sends you a determination. If you disagree, for example because you believe the worker was discharged for misconduct and should be disqualified, you have 30 days from the determination’s mail date to file a protest.⁴

The fastest route is your MiWAM employer account, under “UI Tax,” then “Account Services,” then “View Determinations and Decisions.” You can attach supporting documents directly in the portal. You can also download Form UIA-1733, complete and sign it, and submit it by fax to 1-517-636-0427 or by mail to the Unemployment Insurance Agency, P.O. Box 169, Grand Rapids, MI 49501-0169. A protest filed after the 30-day window is still accepted, but you will need to include an explanation for the delay.⁴

Keep a copy of every completed UIA-1711 you deliver. Good separation records strengthen your position if a claim reaches the protest or appeal stage, and they close off the argument that the notice was never provided.

1
Legal Information Institute. Michigan Administrative Code R 421.204 – Unemployment Compensation Notice to Employee
2
State of Michigan. Unemployment Compensation Notice to Employee
3
Pure Michigan Talent Connect. Unemployment Information
4
Michigan Department of Labor and Economic Opportunity. Protests and Appeals