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of the Commonwealth of Pennsylvania

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    UC-1681: Surety Bond
    This form is a contract/bond between a reimbursable employer's insurer and the Department of Labor and Industry. It serves as collateral in the event UC benefit charges are unpaid and will be liquidated up to the stated amount of the contract/bond.

    You must also complete Form UC-1692, which is used to determine the amount of the contract/bond.

    UC-1692: Election Or Re-election of Reimbursement 


    This form is the agreement an employer must complete to elect reimbursable coverage.

    Completed forms should be mailed to:

    Department of Labor & Industry
    Office of UC Tax Services
    PO Box 68568
    Harrisburg, PA 17106-8568