Find Out Your Savings Potential

Fill out the savings evaluation form below to find out whether you qualify to join, and how much you’ll save! Or click here to download the form and fax it to 805-566-4921. If you have any questions about filling out the form, please don’t hesitate to contact us at 1-888-249-4668 or email us at info@ChooseUST.org. We’re here to help!

UST Savings Evaluation

Please note: Eligibility in UST is determined based on your claims experience and financial stability. Only 501(c)(3) agencies with a minimum of 10 full-time employees are eligible to join the Trust.

Is your agency a nonprofit 501(c)(3) organization?*
Does your organzation have 10 or more employees?*
Agency/Organization Name*
Address Information*

Street Address
City

State
Zip Code
Phone*
Contact Name*
Email*
How many of your employees are full time?*
How many of your employees are part time?*
To receive a savings evaluation, complete part 2 below. If you need assistance completing this form or have questions, call us at 1-888-249-4668 or email info@chooseUST.org.
How did you hear about UST?*

Be sure to tell us if you heard about us through one of our Sponsor partners!
Are you currently paying a state unemployment tax rate or directly reimbursing the state for claims?*
- Tax Rated
- Reimbursing
If you selected tax rated, what is your current unemployment tax rate?

You can find your agency’s tax rate on the tax rate notice you received from the state.
What are your annual SUI/SUTA taxable wages?*

Refer to your last four quarterly wage reports to calculate annual amount. They may be referred to as SUI, SUTA or state unemployment taxable wages.
What are your gross annual wages?*
Are you anticipating layoffs or loss in funding in the next 24 months?*
Total dollar amount of claims paid in 2009*
Total dollar amount of claims paid in 2010*
Total dollar amount of claims paid in 2011*
Total dollar amount of claims paid in 2012 YTD*

Join UST

Find Out Your Savings Potential

UST Savings Evaluation