Section 63 Notice to Last Employer of Claim Filed for Unemployment Benefits

• Library: Employer-Employee Law 2008 Forms

MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS DIVISION OF EMPLOYMENT SECURITY

INITIAL CLAIM

MISSOURI DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS

Division of Employment Security

Notice to last employer of claim filed for unemployment benefits Date mailed: 11-28-06

BEN

EMPLOYER:

DIRECT INQUIRIES OR PROTEST TO
MO DIV OF EMPLOYMENT SECURITY
P O BOX 8859
ST LOUIS MO 63101
FAX (314) 340-4755

CLAIMANT NAME:

SSN:

BENEFIT YEAR BEGINNING DATE: 11-26-06

The claimant named above has filed a claim for unemployment benefits. If you are a Missouri employer who paid wages to the claimant during the base period of the claim, your account may be subject to charges for benefits paid. You can identify the claimant by checking the social security number against your payroll records. If the claimant name on this notice does not match your records...