Payment Coupon

The Payment Coupon page generates a Payment Coupon to attach to your check.  It also contains a sample format for completing your check.  

Reminders:

• Make your check payable to Department of Workforce Development

• Include your UI account number on the check  

• Enter the amount of your check in the Payment Amount field

• Print the Payment Coupon

• Staple your check to the Payment Coupon

• Mail the coupon and check to:

Indiana Department of Workforce Development

P.O. Box 7054

Indianapolis, IN 46207-7054

Select “Next” to continue or “Cancel” to delete your data and return to the Payment Details and Options page.