State of Maryland, Department of Labor, Licensing, and Regulation
Separation Form Help
OVERVIEW
The “Request for Separation Information” (DLLR/DUI 207) is sent to an employer when a former employee files a claim for unemployment insurance benefits.  This form serves two purposes: it informs the employer that a claim has been filed, and it requests that the employer provide the reason for separation.  The facts presented on this form will be used to determine the claimant's eligibility for benefits.  The employer is required to provide this information under the Maryland Unemployment Insurance Law.
Employers must complete and return the "Request for Separation Information" by the due date (eight calendar days from the date the form is issued) or be assessed a $15 penalty per Section 8-627 of the Maryland Unemployment Insurance Law.
Employers may respond in one of two ways to the “Request for Separation Information”
(DLLR/DUI 207):
By mail (to the address appearing on each form); or
Via the Internet (http://www.mdunemployment.com)
Note: A confirmation number will be provided once the transaction has been completed.
If the employer fails to return the form by mail or via the internet and the due date has past, benefits will be paid if the claimant had indicated that he/she was separated due to lack of work or temporary layoff, as long as, all other requirements of the law are met.
Employers can prevent improper benefit charges to their accounts and claimant overpayments by providing accurate information in a timely manner.
If employers provide false information for the purpose of disqualifying a claimant, they may be subject to criminal, as well as, civil penalties.
If you feel that this form has been sent to you in error, it must still be completed.  You may have employed this individual for only a brief time or even over a year ago.  When an individual files a claim for unemployment insurance benefits, all employment during the previous 18 month period must be examined.  Any employer during those 18 months can potentially be charged for benefits if the claimant is determined to be eligible.  It is important that you respond to this request to ensure benefits are paid properly to the claimant and charged, or non-charged correctly to your employer account.
There are several options available when completing the form.  In most cases, you will select a "Reason for Separation" from the list provided.  Make a selection that best describes the reason the individual is temporarily or permanently separated from your employment.
PAYMENTS
The PAYMENTS section provides an area for you to report information on certain types of payments that the claimant has received or will receive as a result of his/her separation from employment with your company.  This section does not request information on earned wages paid to the claimant for work performed prior to leaving employment.
If the claimant has received or will receive one of the following types of payments from your company after the last day of employment, you must check the box to the left of the payment type and complete certain questions regarding the payment.  Do not check the box unless the payment meets the conditions listed for each type of payment.
Pension
The receipt of a pension or annuity from a base period employer may reduce or prevent the payment of UI benefits.  If the claimant contributed to the pension, 50% of the retirement payment will be deducted from any benefits due.  If the pension contribution was made solely by the employer, 100% of the payment will be deducted from any benefits due.  If the retirement payment is paid in the form of a lump sum, it will not be deductible from benefits if:
the employer pays the lump sum payment as a result of a layoff or shutdown; or
within 30 days of receiving the lump sum payment, the claimant places the payment in a qualified retirement plan and provides proof that it has been placed in that plan.
Only report pension payments in this section that the claimant is currently receiving or will begin receiving within the next year.
Profit Sharing
The receipt of a profit sharing payment may be deductible from UI benefits only if the profit sharing payment is part of a retirement or pension plan account.  Do not check this box unless the payment meets this criteria and has been paid or will be paid within the next year.
Bonus or Special Pay
The receipt of a bonus or special payment will only be deducted from UI benefits if the claimant performed services during the week the payment is made or to which the payment is attributable.  If the payment was paid or is attributable to a week prior to the effective date of the claim displayed on the first page of the online form, do not report the payment, as it will not affect the payment of benefits.
Severance Pay
The receipt of severance pay is always disqualifying.
Severance pay is deducted from UI benefits on a daily basis beginning with the day following the last day of work and until all money has been allocated.  The severance pay amount and gross weekly wage is needed to correctly allocate the payment.
Vacation or Holiday Pay
The receipt of vacation or holiday pay will be deducted from UI benefits if on or before the last day of work, the claimant is notified by the employer of a definite return to work date.  If there is no definite return to work date, the vacation or holiday pay will not be deducted from benefits.  The amount of vacation and or holiday pay received and the dates for which it is paid are requested.
This payment option is only available if the separation reason selected when completing the Request for Separation Information form online meets the above criteria.
ADDITIONAL INFORMATION
The following additional information provides the format in which data should be entered on the form and some hints that may be helpful when completing the form.
Required Fields (*)
Any field that has an asterisk before it is a required field.  If you are unable to fill out all of the required fields on the online form, you will need to submit the request you received by mail.  Please be aware that the law provides penalties for false statements.
Internet Key\(PIN)
If you are receiving paper "Request for Separation Information" forms, the Internet Key\(PIN) is located in the top right area on the front of the form.  If you are unable to locate the form then you will need to request the key from DLUI‑DLLR@maryland.gov.
Maryland Employer Account Number
The Maryland Employer account number for the employer shown in this application is the account number that matches the employer name given to us by the claimant.  If the number is not correct for the employer name listed, please enter the correct Maryland employer account number in the area provided.
Gross Wages and Other Payment Amounts
Any wage amount entered in this application should adhere to the following formatting rules:
A. Do not enter a dollar sign ($) within the field
B. Do not enter any commas (,) within the field
To Change Your Company's Address
If you change your company's address or telephone number, you will need to notify the Division of Unemployment Insurance (DUI) immediately by one of the following methods:
If you use the Maryland Unemployment Insurance WebTax application to file your quarterly employer Contribution and Employment Report, you may also use it to change the company address or telephone number, or
You may call the Employer Status Unit at 410-767-2414, or
You may email your changes to dluitaxstatus‑dllr@maryland.gov.  Please include your Maryland Unemployment Insurance employer account number, your name and telephone number when emailing your changes.
To Report an Employee’s Recall to Work or Job Refusal
If an employee refuses a recall to work or an individual refuses an offer of work, you must notify the Division of Unemployment Insurance (DUI) within 15 days after the refusal in order for DUI to consider whether the refusal will affect the individual's benefits.  This notification may be sent via email to DLUI‑DLLR@maryland.gov.  Please include all of the following: date of offer, date of refusal, name and SSN of the individual, your company name and Maryland Unemployment Insurance employer account number.
To Contact Us
If you have any questions regarding the completion of the Request for Separation Information form, you may contact one of the Division of Unemployment Insurance (DUI) offices listed below.  These numbers are only to be used by employers for clarification on unemployment insurance benefit issues.  Claimant inquiries will not be answered at these numbers.
College Park Claim Center – 301-313-8037
Cumberland Claim Center – 301-723-2145
Salisbury Claim Center - 410-334-6868
Towson Claim Center – 410-853-1713
Help with SIDES E-Response: dluisides‑dllr@maryland.gov