New york state department of labor unemployment insurance division claim service subsection 2016-201-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Claimant’s Name and SS Number in the designated fields. Ensure accuracy as this information is crucial for processing your claim.
3. Fill in the Date(s) of Hearing and Appeal Case Number. This helps track your case effectively.
4. Indicate the Date Retained and Date Representation Ended, which are important for establishing timelines.
5. Complete the Total Amount of Expenses/Fees PAID by Claimant to date and Total Fee Requested. Be clear about any pre-paid amounts included.
6. In the ITEMIZED SERVICE section, list services provided (e.g., research, preparation) along with ACTUAL TIME REQUIRED for each service.
7. Certify the information by providing your Printed Name, email address, Signature, Street Address or P.O. Box, and Telephone Number.
8. Review all entries for completeness before submitting. Ensure all pages are filled out correctly.

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