Instructions For Form Ucb-I 14 - Low Earnings And Partial Claim Report

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12.
15.
16.
17.
Barnwell .......... ,450 I I
Beaufort .......... .450 I3
Clarendon
Horry
Newberry ....... .4507 I
Pickens .............. 45077
Richland ............ 45079
Anson .............. .37007
Gaston ............. .3707 I
Haywood ......... .37087
Robeson _._____._._ 37 I55
Bulloch . . . . . . . . . . . . . I303 I
Chatham . . . . . . . . . . I305 I
Effingham _..__..... I30 I3
Screven ............. I 325 I
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This form, UCB-I 14, Low Earnings and Partial Claim Report is machine read and must be completed in BLACK INK or typewritten. Sections 2 through 14 of this form
must be completed by the employer. The worker must complete sections I5 through 18. The certification must be signed by both the worker and the employer, or a
designated employer representative whose signature is on file in the unemployment insurance office.The instructions below indicate exactly what information is required in
the spaces on the form itself. Contact your nearest unemployment insurance office if you have any questions.
The UCB-I 14, Low Earnings and Partial Claim Report must be submitted by the employer. It will not be accepted directly from the worker.The form will be returned to you
if it is not complete and legible. This form must not be completed or submitted until the claim week has ended. A claim week consists of a 7-day period
ending on Saturday. Claims should be submitted the first work day following the week of partial unemployment.
I.
Leave this item blank
Enter the worker’ s name and mailing address, and any other name worked under while in your employ if different than current one.
2-4.
Enter the county name and code where the worker resides as explained in the chart below.
5.
6.
Enter the worker’ s social security number.
Enter the date (example 09-20-97) the claim week ends. A claim week consists of a 7-day period ending on Saturday. (This dote must be seven or more days from the
7.
prior claim week ending dote.)
Indicate the worker’ s sex and ethnic characteristics.
8.
Enter the employer account number assigned by the South Carolina Employment Security Commission.
9.
Enter the company’ s name and telephone number. (Occosionolly, we have to cull the employer concerning this form.)
IO.
Enter any wages earned with this employer during the claim week. Include in this amount any vacation earnings, as well as any other earnings made with any other
I I.
employer during the same claim week.
If receiving a pension or retirement payment, enter the amount.This should be the gross pension before deductions are made. Only show that amount of pension or
retirement that the employer paid and follow that amount with the Letter “C.” If receiving social security payments, indicate only one-half f//2) the monthly amount
being received. (Widows’ pensions should not be entered.)
13.
Indicate if this worker is a corporate official of this business.
If the business is a proprietorship or a partnership, indicate if the worker is the child of (less then 18 yeors ofage), or the spouse or parent of the employer. If the
14.
business is incorporated mark this answer “NO.”
Indicate whether or not the address entered in items 3,4. or 5 has changed since the last week of unemployment insurance benefits claimed.
The worker must indicate whether or not he is a citizen/national of the United States. If the answer to this question is “NO.” then complete item 17.
If the worker answers “NO” to item 16. he must indicate whether or not he is in satisfactory immigration status. Once a UCB- I I4 is received for a worker in this
category, he will be instructed to report to the local offtce with his original work authorization documents.These documents must be examined before benefits can be
paid. Although the worker must indicate his status on each UCB- I I4 submitted.once these documents have been initially examined by the local office (this is done time
process) all subsequent UCB- I 14s will be processed without delay.
18.
Worker should provide telephone number.
WORKER’ S CERTIFICATION: The worker must read the certification. and if he agrees with the statement, have him sign the form.
DATE OF PREPARATION: Enter the date this form was completed.
EMPLOYER’ S CERTIFICATION: The authorized employer representative must sign this form after it has been completed and signed by the worker.The individual who
signs this form (employer or employer representative) must have his signature on file as an authorized signatory
in the local unemployment insurance offke where this claim is
filed.
YOU SHOULD NOT COMPLETETHIS FORM IFTHE E M P L O Y E E W A S N O T A B L E
TO WORKANDAVAILABLE FORWORK DURINGTHE WEEK CLAIMED.
Please indicate the county in which the worker lives by entering the county name and code in item 5 of form.The county names and codes are given below. If the worker
lives in a county not shown below, indicate the county name only in item 5.
SOUTH CAROLINA
N O R T H C A R O L I N A
G E O R G I A
C O U N T Y . . C O D E
COUNTY . ..CODE
COUNTY . . CODE
COUNTY . ..CODE
COUNTY . . CODE
COUNTY . ..CODE
Abbeville ......... .4500 I
Greenwood .... .45047
Lincoln .
Banks . . . . . . . . . . . . . . . . I30 I I
Jenkins .............. I3 I65
37 IO9
Aiken ................. 45003
Hampton ......... .45049
Bladen .............. ,370 I7
McDowell . . . . . . . . . 37 I I I
Bryan . . . . . . . . . . . . . . . . I3029
Lincoln .............. I3 I8 I
Brunswick ....... ,370 I9
Madison ............ I 3 I 95
Allendale ......... .45005
................ 4505 I
Macon . . . . . . . . . . . . . . . 37 I I3
jasper ................ 45053
Buncombe.. ..... .3702 I
Oglethorpe.. .... I322 I
Anderson ........ .45007
Mecklenburg.... 371 I9
Burke . . . . . . . . . . . . . . . . I3033
Bamberg .......... .45009
Kershaw .......... .45055
Cleveland ........ .37045
Polk . . . . . . . . . . . . . . . . . . 37149
Rabun.. .............. I324 I
Lancaster.. ........ 45057
Columbus ....... .37047
Richmond
37 I53
Columbia . . . . . . . . . I3073
Richmond.. ....... I3245
Laurens ............. 45059
Lee.. ................... 4506 I
Stephens.. ......... I3257
Berkeley .......... .450 I5
Rutherford . . . . . . . 37 I6 I
Elbert . . . . . . . . . . . . . . . . I3 IO5
Calhoun ........... ,450 I7
Lexington ........ .45063
Henderson.. .... .37089
Scotland . . . . . . . . . . . . 37 I 65
Franklin . . . . . . . . . . . . I3 I I9
Towns ............... I328 I
Charleston ...... ,450 I9
McCormick ...... 45065
Hoke ................ .37093
Transylvania 37175
Habersham . . I3 I37
White ............... I33 I I
Cherokee ........ .4502 I
Marion ............. .45067
Jackson ............ .37099
Union .
37 I79
Hart .
. I3 I47
Wilkes .............. I33 I7
Marlboro ......... .45069
Chester ........... .45023
Chesterfield .... .45025
Oconee ........... .45073
....... .45027
Colleton .......... .45029
Orangeburg.. .. .45075
Darlington ...... .4503 I
Dillon ............... .45033
Dorchester .... ..4503 5
Saluda.. .............. 4508 I
Edgefield .......... .45037
Spartanburg.. ...4508 3
Sumter .............. 45085
Fairfield ............ .45039
Florence .......... .4504 I
Union ................ 45087
Williamsburg.. .45089
Georgetown.. . .45043
Greenville ....... .45045
York.. ................. 4509 I
UNEMPLOYMENT INSURANCE

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