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01. Edit your determination of potential chargeback for the employer online
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How to use or fill out Notice to Protest Benefit Charges. Chargeable Employers with our platform
- 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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