Form 54244 2012-2019-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Claimant Name and Social Security Number in the designated fields. Ensure accuracy as this information is mandatory for processing.
3. Fill in the Benefit Year End, followed by the Claimant's Street Address, City, State, and ZIP Code.
4. Next, provide the Employer's name and Indiana SUTA (Employer Account Number), along with their address details.
5. Indicate the employment period by entering the start date and last day worked using the mm/dd/yyyy format.
6. Select the Reason for Protest by checking all applicable boxes. Each reason has a specific code that should be noted.
7. If applicable, include a Brief Statement of Facts regarding separation in the provided section.
8. Finally, enter your contact name, date, and signature before submitting. If you have additional documents, check the box and indicate how many pages are attached.

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