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Notice to Protest Benefit Charges. Chargeable Employers 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Employer Information section. Enter your Employer Name/DBA, Phone Number, Address, Account Number, and FEIN accurately.
- Next, provide Claimant/Claim Information. Fill in the Notice of Claim Reply Due Date, Claimant SSN, Suffix, Claim ID Number, Last Name, Middle Initial, First Name, and any Other Last Name.
- Select one of the options regarding your employment of the claimant and complete all related fields. For example, if you did not employ the claimant for 30 days, enter the Start Date and End Date along with Total Number of Days Worked.
- If applicable, provide details about leased employees by identifying the leasing agency's name and address.
- Finally, certify that the information is true by printing your name, signing it, adding your title and contact information before saving or submitting the form.
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potential chargeback for the employer
Mar 7, 2016 You will be charged for any benefits paid to him/her. Benefits paid to him/her will be assessed to your UI Account as the Chargeable Employer.Read more
Dec 11, 1997 The contractor shall provide a copy of the NRC DPV procedure to all of its employees performing under this contract and to all subcontractorsRead more
Any employing unit that receives a notice of the filing of a claim may protest payment of benefits to former employees or charges to the employer if the protestRead more