Looking for a West Virginia Legal Forms And Templates? Download it for free!

INSTRUCTIONS FOR COMPLETING INITIAL CLAIM/LOW EARNINGS REPORT

You are required to issue an Initial Claim/Low Earnings Report, Form WVUC-B-6-11, to any full-time

employee on or before the payday for the week(s) in which the worker is partially unemployed due to lack

of work. This form should be issued to all full-time workers that are still on your payroll for each calendar

week (Sunday through Saturday) that the employees’ earnings for the week are reduced because of lack

of work. You need not issue Initial Claim/Low Earnings Reports to employees who have earned as much

as the maximum weekly benefit amount plus $60.00.

The Initial Claim/Low Earnings Report contains spaces for entering data for two weeks.

The numbered instructions below relate to numbered items on the upper portion of Form WVUC-B-6-11.

1. Enter the worker’s name and Social Security Number as they appear on the Social Security

card.

2. Enter your employer name, address, and account number. Use the registration number issued

by the Bureau of Employment Programs, NOT your identification number issued by the Social

Security Administration. (Your account number appears on your Quarterly Wage and Contribution

Reports, Forms WVUC-A-154 and WVUC-A-154-A).

3. Indicate by marking “Yes” or “No” if the worker is a U.S. citizen.

4. Certification: See Items 5, 6, 7, and 8 below.

5. Week Ending Date: This date must always be a Saturday date. Initial Claim/Low Earnings

Report should be issued on a calendar week (Sunday through Saturday) basis only. Each week

should be a full seven days – no more, no less.

6. Earnings: Enter the gross wages earned by the employee for the week before deductions for

taxes, insurance, etc. If the employee had no earnings for the week, enter “None” or “0.”

7. Other Income: Enter the amount of holiday pay, vacation pay, sick leave pay, or other type of

income paid to the employee for the week. Identify the type of pay in “REMARKS.” If the

employee had no other income for the week, leave blank.

8. REMARKS: An Initial Claim/Low Earnings Report should be prepared only if the employee’s

earnings for the week were reduced because of lack of work. If the employee’s reduced earnings

were due even in part to another cause, such as illness, disability, nonavailability or absence for

any reason other than lack of work, explain this fact in the “REMARKS” space.

Signature: The employer or employer’s representative must sign the Initial Claim/Low Earnings

Report. The typed name will not suffice. A stamped signature or computer-generated signature is

acceptable.

Title: Enter the title (Owner, President, Secretary, etc.) of the person signing the Initial Claim/ Low

Earnings Report.

Date Issued: Enter the date the Initial Claim/Low Earnings Report was issued to the employee.

Give or mail Form WVUC-B-6-11 to the employee. (The lower portion is an Initial/Continued Claim

Form.) The employee may bring the completed form to the claims office or complete the claim and

mail the form to the claims office.

Form Wvuc-D-82 - Notice To Employer/claimant Regarding Initial Claim/low Earnings Report Page 2