Dol agenciesetaContactU S Department of Labor 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your employer information, including the account number, street address, city, state, zip code, and telephone number.
3. In section 1, select the reason for the mass separation by checking the appropriate box. If applicable, provide details such as dates of natural disasters or vacation periods.
4. Fill in the last day worked and expected return to work date in sections 2 and 3 respectively.
5. Indicate whether your company provides services to educational institutions in section 4 and answer any follow-up questions.
6. Complete section 5 regarding worker retirements and provide necessary details if applicable.
7. Finally, certify that all information is true by signing and providing your printed name, title, contact number, and email address.

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