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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the claimant's name and Social Security number in the designated fields. Ensure accuracy as this information is crucial for processing.
- Indicate the claimant’s last day worked using the mm/dd/yyyy format. If applicable, specify whether the claimant is still considered an employee by selecting 'YES' or 'NO'. If 'NO', provide the date employment ended.
- Fill out the reason for separation and indicate if school is currently in session. If it is, provide the beginning and ending dates of any breaks.
- If there is reasonable assurance of returning to work, complete the relevant section with return dates and positions held before and after school closure.
- For bus drivers, answer whether their job involves transporting for non-school-related functions, detailing frequency and gross wages per trip if applicable.
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