Unemployment Power of Attorney Forms

To designate ADP as your unemployment benefit claims processor, complete the required power-of-attorney (POA) authorization for each state in which your company pays wages. Certain states require registration via their website.

Scroll this page to view the required form(s) or instructions. Each can be viewed or downloaded by clicking the appropriate link. Forms that are downloaded may be filled-in and saved.

Completed forms should be scanned and sent via email to poa@adpunemploymentclaims.com.

Our POA Processing team will review your submission and notify you if any changes are necessary. Once the review is complete and any corrections are made the required original form(s) must be sent to the address below. Forms that do not require an original can be emailed to the address above. ADP will execute and file any authorization with the appropriate agency. It is important to note that certain states do not have a POA form to complete but require you to register online. Instructions on how to register ADP Unemployment Claims online can be downloaded from this page as well.

ADP Unemployment Claims – POA Processing
Mail: P.O. Box 1390; Londonderry, NH 03053-1390
Courier: 50 Nashua Road, Unit 2; Londonderry, NH 03053

The forms and instructions provided are for informational purposes and represent ADP’s understanding of the applicable requirements of the respective state unemployment agency. These resources are updated periodically or when ADP learns of a new or modified form or other requirement.

 

Alaska

state form AK POA is required. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


Alabama

state form AL POA is required. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


Arizona

state form UIT-1146A is required. A corporate officer or the owner of the business must sign the form. A copy of the form is acceptable. Back to top


Arkansas

accepts ADP form UC 6018N. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


California

State form DE 48 is required. A corporate officer or the owner of the business must sign the form. The signer of this form must be on file with California EDD. A copy of the form is acceptable. Back to top


Colorado

state form UITL-18 is required. All fields must be complete and all signatures must be dated less than six months prior to submission. A physical business address within the State of Colorado must appear on the form. If your company does not have a physical location then a work location of your Colorado employees must be stated. A copy of the form is acceptable. Back to top


Connecticut

state form UC-424 is required. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


Delaware

state form DE POA is required. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


District of Colombia

agency form D-2848 is required. A copy of the form is acceptable. Back to top


Florida

state form DR-835 is required. Section 1 and Section 8 must be completed by the employer. State form RTS-3 is required. Section 1 and Section 7 must be completed by the employer. A scanned copy of the form is acceptable so long as the original is maintained as a business record. Florida also requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the FL Online assignment instructions. Back to top


Georgia

state form DOL‐2867 and state form GA POA are required. Forms must contain an original signature. A copy is not acceptable. Back to top


Hawaii

accepts ADP form UC 6018N. A corporate officer or the owner of the business must sign the form. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on form must be original; a copy is not acceptable. If the company structure is anything other than as sole proprietorship, a list of officers, partners, or principals must be included on company letterhead. The list must contain full name, current title, last four digits of the social security number, and dates of service for each person listed. If any piece of data is missing from the list of officers form UC 6018N will be rejected. Back to top


Idaho

accepts ADP form UC 6018. A copy of the form is acceptable. Idaho also requires employers to visit the state website to assign ADP access to view benefit charge information. Review the ID Online assignment instructions. Back to top


Illinois

state form LE-10 and UI-1M are required. A copy of the form is acceptable. Back to top


Iowa

state form 68-0092 is required. A copy of the form is acceptable. Back to top


Indiana

requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the IN Online assignment instructions. Back to top


Kansas

state form K-CNS-032 is required. A corporate officer, principal, or the owner of the business must sign the form. A physical business address within the State of Kansas must appear on the form. If your company does not have a physical location then a work location of your Kansas employees must be stated. A copy of the form is acceptable. Back to top


Kentucky

state form KY POA is required. A copy of the form is acceptable. Back to top


Louisiana

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Louisiana also requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the LA Online assignment instructions. Back to top


Maine

state form UC-28 is required. A corporate officer, principal, or the owner of the business must sign the form. A copy of the form is acceptable. Back to top


Maryland

state form MD POA is required. A corporate officer, authorized individual or the owner of the business must sign the form. A copy of the form is acceptable. Back to top


Massachusetts

requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the MA Online assignment instructions. Back to top


Michigan

Complete ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. Signature(s) on form can be original or digital; a copy of the form is acceptable. Back to top


Minnesota

requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the MN Online assignment instructions. Back to top


Mississippi

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Missouri

state form MODES-4444 is required. A corporate officer, authorized individual or the owner of the business must sign the form. A copy of the form is acceptable. Back to top


Montana

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Nebraska

state form NE POA is required. A corporate officer, principal, owner or fiduciary of the business must sign the form. A copy of the form is acceptable. Back to top


Nevada

requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the NV Online assignment instructions. Back to top


New Hampshire

accepts ADP form UC 6018. A corporate officer or owner of the business must sign the form. A copy of the form is acceptable. Back to top


New Jersey

state form NJ POA is required. A state-sanctioned notary public must notarize signature(s) on this form and the form must have an embossed corporate seal. If a corporate seal is not available, indicate that on the POA prior to it being notarized. Be sure to fill in all blank lines except for the signature on the lower right-hand corner. Officer must sign in two places. Signature(s) and corporate seal on the form must be original; a copy is not acceptable. Back to top


New Mexico

requires employers to visit the state website to assign authority to ADP as their TPA (third party administrator) for unemployment matters. Review the NM Online assignment instructions. Back to top


New York

state form IA 900 is required. Signature(s) on this form must be notarized by a state-sanctioned notary public. Signature(s) on form must be original; a copy is not acceptable. Back to top


North Carolina

state form POA1 is required. A corporate officer or the owner of the business must sign the form. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. If the company structure is anything other than as sole proprietorship a list of officers, partners, or principals must be included on company letterhead. The list must contain full name, current title, and dates of service for each person listed. If any piece of data is missing from the list of officers form POA1 will be rejected. Back to top


North Dakota

state form SFN-59128 is required. A corporate officer, principal, owner or fiduciary of the business must sign the form. A copy of the form is acceptable. Back to top


Ohio

state form JFS-00501 is required. A corporate officer or owner of the business must sign the form. A copy of the form is acceptable. Back to top


Oklahoma

state form OES-190B is required. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) on the form must be original, a copy is not acceptable. Back to top


Oregon

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Pennsylvania

state form UC1208 is required. An authorized employer representative signature is required. The POA must be submitted within three months of the signature date. A copy of the form is acceptable. Back to top


Puerto Rico

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Rhode Island

Complete ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. Signature(s) on form can be original or digital; a copy is acceptable. Back to top


South Carolina

state form UCE-1010 is required along with the attached UCE-101 change of address form. Both forms must be an original and both must be signed. A copy is not acceptable. Back to top


South Dakota

state form SD POA must be used. Signature(s) on the form must be original; a copy is acceptable. Back to top


Tennessee

state form LB-0927 is required. An authorized employer representative signature is required. A copy of the form is acceptable. Back to top


Texas

state form BR-001 and state form C42 and C43 are required. Signature(s) on forms must be original; a copy is not acceptable. Back to top


Utah

state form UIC-POA is required. A state-sanctioned notary public must notarize signature(s) on this form. A scanned copy of the form is acceptable so long as the original is maintained as a business record. Back to top


Vermont

state form C-50 is required. A corporate seal and witness signature are required. If a corporate seal is not available, indicate that fact on the POA prior to it being notarized. A state-sanctioned notary public must notarize signature(s) on this form. Signature(s) and corporate seal on the form must be original, a copy is not acceptable. Back to top


Virginia

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Virgin Islands (US)

accepts ADP form UC 6018 with a signature and printed name of the corporate officer, authorized signer, principal, or owner of the business. A copy of the form is acceptable. Back to top


Washington

state form WA POA is required. A corporate officer, owner or authorized signer of the business must sign the form and fill in Section 2. A copy of the form is acceptable. Back to top


West Virginia

accepts ADP form UC-6018WV. A state-sanctioned notary public must notarize signature(s) on this form and the form must have an embossed corporate seal. If a corporate seal is not available, indicate that on the POA prior to it being notarized. Signature(s) and corporate seal on the form must be original, a copy is not acceptable. Back to top


Wisconsin

state form UCT-8291 is required. A corporate officer, owner or authorized signer of the business must sign the form. The signature of a witness is required. A state-sanctioned notary public must notarize signature(s) on this form. The notary may also sign as the witness. Signature(s) on the form must be original, a copy is not acceptable. Back to top


Wyoming

state form DFC041 is required. A corporate officer, owner or authorized signer of the business must sign the form. A copy of the form is acceptable. Back to top