Notice To Federal Employee About Unemployment Insurance printable pdf download

Notice To Federal Employee About Unemployment Insurance

Released 5/29/99.

NOTICE TO FEDERAL EMPLOYEE ABOUT UNEMPLOYMENT INSURANCE

This form has been given to you because (1) you have been separated from your job, or (2) you were placed in a nonpay status, or (3) your

records have been transferred to a different payroll office.

Unemployment insurance (UI) for Federal workers. When unemployed, Federal workers may be entitled to UI benefits

similar to those of workers in private industry. If you become unemployed or are in a nonpay status and want to FILE

A CLAIM, go to the nearest LOCAL PUBLIC EMPLOYMENT SERVICE OFFICE of the STATE EMPLOYMENT

SECURITY AGENCY to register for work and file your claim for UI. Your ELIGIBILITY for UI CANNOT be determin-

ed until AFTER you file a claim. DO NOT DELAY filing a UI claim; if you wait, your unemployment benefits may be reduc-

ed or you may not qualify for any benefits.

To help EXPEDITE your claim, take THIS FORM with you, your SOCIAL SECURITY ACCOUNT NUMBER CARD, the OFFICIAL

NOTICE of your most recent SEPARATION or of your present NONPAY status (Standard Form 50 if available), EARNINGS and LEAVE

statements, or similar documents that indicate you were employed by a Federal agency.

3 Digit

Identification

FEDERAL AGENCY

To be completed by the Federal

FEDERAL AGENCY will insert

Agency:

in the box:

Library of Congress

CODE NO.

1st line--Parent Federal Agency

030

Human Resources Services,

Contact Name/Office

Name and 3 digit code number

Technical Services Group

2nd line--Major Component (if

101 Independence AVE SE

Robin Patterson,Worklife Services Ctr

any)

Telephone No. (include area code)

3rd and 4th line--complete

Washington, DC 20540

address to which all forms

(202) 707-7191/ fax: (202) 707-1454

pertaining to a claim should be

sent (ES-931, 931A, 934, 936, and

notices of appeal, hearings, and

determinations)

KEEP THIS FORM and TAKE IT WITH YOU if you file a UCFE/UI claim for unemployed Federal workers provided by Federal law

(U.S. CODE, Title 5, Chapter 85). For more information about UCFE/UI, read the REVERSE SIDE of this form.

STANDARD FORM 8 (Rev. 6/87)

Prescribed by Dept. of Labor

NSN 7540-00-634-3964

8-106

20 CFR 609

Notice To Federal Employee About Unemployment Insurance

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