Separation Notice Form (Page 3 of 3) in pdf

Separation Notice Form Page 3

INSTRUCTIONS TO THE WORKER

Having become unemployed, you should go to a Business and Career Solutions Center most

convenient to you and register for work. If you intend to file a claim for benefits, you may do so at the same

time or file a claim via the Call Center at 1-866-783-5567. Under the Louisiana Employment Security Law,

you may be disqualified for benefits, if it is determined that:

You left your work without good cause attributable to a substantial

change with your employment, or

You were discharged for misconduct connected with your work, or

You failed to accept suitable work when offered or to apply for available

suitable work, when so directed by the Administrator or the employment

office, or

You were taking part in a labor dispute in the establishment in which you

were employed, or you were seeking unemployment compensation benefits

under any other State or Federal Law.

It is important for you to register for work immediately even though you may be temporarily

disqualified for benefits.

In deciding whether you are disqualified, the Louisiana Workforce Commission will consider the

statements made by your employer on Form LWC 77, Separation Notice, concerning the reason for your

separation and the statements you make when you file your claim for benefits. If you do not agree with the

reasons for leaving your job as given on the Form LWC 77, Separation Notice, provide a detailed statement

on your Unemployment Insurance Application.

NOTE: It is not necessary to EMPLOY any one to help you collect benefits. Representatives of

the Louisiana Workforce Commission will advise you and help you with your claim.

Center at 1-866-783-5567.

Separation Notice Form Page 3