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IS790C (6/22/99) Cover Sheet

99) Cover Sheet 2025

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The document is a cover sheet for a claimant's hearing regarding unemployment benefits. It requests the claimant to provide detailed information about their separation from their employer, including reasons for leaving, employment details, and any severance or vacation pay received. The claimant must complete a questionnaire and return it within ten days to determine eligibility for benefits.

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Click ‘Get Form’ to open the IS790C Cover Sheet in the editor.
Begin by entering your Case Number, Social Security Number, and Employer Name at the top of the form. Ensure accuracy as this information is crucial for processing your claim.
Fill in your contact details, including Telephone Number and Fax Number, to facilitate communication regarding your claim.
In the Claimant Separation Statement section, provide employment dates and total gross earnings. Specify your final rate of pay and type of work performed.
Indicate your reason for separation by checking the appropriate box. If applicable, provide detailed explanations in the Additional Statement section.
Complete any additional questions regarding severance pay or vacation pay as required. Attach any necessary documentation directly within the editor.
Finally, sign and date the Certification at the bottom of page 4 to validate your submission before sending it back within ten calendar days.

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Versions	Form popularity	Fillable & printable
2018	4.1 Satisfied (57 Votes)

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