Purpose
To notify you of the determination made on a claim for unemployment benefits filed by your former employee. (See Form)

Use
This notice will be mailed to you immediately after we have made a determination. This notice is for your records and need not be returned.

Use by Employer
When you receive one of these forms, you should read the reason given for the determination.  If you wish to appeal the determination, you should take the following steps:

1.  File a request for a hearing, in writing, within the 10-day period shown at the upper right-hand side of the form and as instructed on the reverse of the form.

2.  State in your request the reason(s) why you believe the claimant is not entitled to benefits.

3.  Address your request to the office shown at the upper left-hand side of the form.

You will be notified of the date and time of the hearing after we receive your letter.