How to use or fill out continued claim certification form online
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your name and Social Security Number (SSN) at the top of the form. If your name has changed, include your previous name as well.
- In Part A, answer the questions regarding your work hours for the week claimed. Indicate if you worked more than 32 hours and provide details if applicable.
- Complete each question in Part A carefully, ensuring you provide accurate information about any additional employment and your availability for work.
- Sign and date the certification statement at the bottom of Part A, confirming that all information is true and complete.
- If applicable, provide your new address below your signature before submitting the form to your employer for completion of Part B.
Start using our platform today to fill out your continued claim certification form online for free!
Fill out continued claim certification form online online
It's free
It's free
See more continued claim certification form online versions
We've got more versions of the continued claim certification form online form. Select the right continued claim certification form online version from the list and start editing it straight away!
Security and compliance
At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.
Learn more