Unemployment Notice Instructions for Employers and Employees
This document provides essential instructions and information regarding unemployment claims in Connecticut. It outlines the responsibilities of both employers and employees during the unemployment process. Ensure that you follow the guidelines to complete the form correctly.
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How do I fill this out?
To fill out this form, first gather all necessary information required for both the employer and employee sections. Carefully read each instruction to understand what details are needed for accurate submission. Double-check your entries to avoid any errors that could delay the claims process.

How to fill out the Unemployment Notice Instructions for Employers and Employees?
1
Gather all necessary information required for the form.
2
Complete the sections for employer and employee accurately.
3
Ensure all details are correct and up to date.
4
Review the information entered on the form.
5
Submit the form according to the instructions provided.
Who needs the Unemployment Notice Instructions for Employers and Employees?
1
Employers who need to notify the state about employee separations.
2
Employees filing for unemployment benefits after losing a job.
3
HR departments managing employee terminations.
4
Job seekers looking to initiate their unemployment claims.
5
State labor officials requiring official separation notices.
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What are the instructions for submitting this form?
To submit this form, ensure that it is filled out completely and accurately. Email the completed form to the appropriate department or fax it to the designated number provided by the Connecticut Department of Labor. You may also mail it to the physical address listed or submit it through any online platform if applicable.
What are the important dates for this form in 2024 and 2025?
The important dates for submitting this form in 2024 and 2025 include the quarterly deadlines for unemployment claims submissions. Due dates for form submissions may vary, so always check the Connecticut Department of Labor website for the latest updates.

What is the purpose of this form?
This form serves a crucial role in documenting unemployment notices for employees separated from their jobs. Its primary purpose is to inform both employers and employees of their rights and responsibilities in the unemployment process. Accurately completing this form helps ensure a smooth transition into unemployment benefits for those eligible.

Tell me about this form and its components and fields line-by-line.

- 1. Employer Connecticut Registration Number: A unique number identifying the employer in Connecticut.
- 2. Employer Name: The legal name of the employer.
- 3. Employer Address: The official address where the employer conducts business.
- 4. Employee Name: The full name of the employee in question.
- 5. Social Security Number: The employee's social security number.
- 6. NCCI Code: The classification code if the employee worked in construction.
- 7. Start Date: The date when the employee began working for the employer.
- 8. Last Day Worked: The final date the employee worked.
- 9. Return to Work Date: The expected date the employee will return, if known.
- 10. Year to Date Earnings: Total earnings of the employee from the start of the year to the last day worked.
- 11. Wages for the Last Week of Work: The employee's earnings for their final week of employment.
- 12. Reason for Unemployment: The reason stated for the employee's separation.
- 13. Dismissal Pay: Indication of whether the employee receives any dismissal pay post separation.
What happens if I fail to submit this form?
Failing to submit this form may lead to delays in the unemployment claims process. Additionally, it could result in complications for the employee seeking benefits. It is crucial to adhere to submission guidelines to avoid such issues.
- Delay in Benefits: Without proper submission, employees may face delays in receiving their unemployment benefits.
- Legal Compliance: Employers may be at risk of non-compliance with state laws regarding unemployment.
- Lack of Documentation: Failure to file the form properly could result in lack of documentation for employment separation.
How do I know when to use this form?

- 1. Voluntary Separation: Use when an employee leaves their job voluntarily.
- 2. Involuntary Termination: Use when an employee is terminated from their position.
- 3. Transitioning to Unemployment: This form is needed for employees transitioning to unemployment benefits.
- 4. Temporary Layoffs: Employers must notify of temporary layoffs that may affect employment status.
- 5. Finalizing Employment Records: Essential for updating employment records to reflect separations.
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