Downloadable forms

Downloadable Forms

Employer Change Request Form
Instructions for completing and returning the Employer Change Request (ECR) form.

You may download, complete, and print this form online, but you will not be able to submit the form via the Internet. In order to make better use of all the features of the form, you should use version 5 of the free Adobe Acrobat Reader.

Once you have completed the form you may either e-mail it as an attachment to cands@mdes.ms.gov, or fax it to 601-321-6173, or print it out and mail it to:

Mississippi Department of Employment Security
Tax Department
P.O. Box 22781
Jackson, MS 39225-2781

Download the Employer Change Request form 

You may download, print, and complete the following forms. Once you have completed a form you will need to mail it to:

Mississippi Department of Employment Security
Tax Department
P.O. Box 22781
Jackson, MS 39225-2781

UI-1 Status Report (Business Registration form)
UI-2/3 R and Instructions-Reporting Quarterly Wages (For reporting period beginning 2011)
UI-2/3 Reporting Quarterly Wages (For reporting periods prior to 2011)
UI-3b Employer’s Quarterly Adjustment Report
ECR- Employer Change Request
940-C – Request for Wage Certification
Refund Request Form
New Hire Card
J-9 Reporting Agent Authorization