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VEC Claim for Benefits

Print this confirmation now, then click the Job Service Registration button to continue. J T VEC' .Y : A monetar determination. T . Your "PIN" (Personal Identification Number) and our BRI (Benefits Rights and Responsibilities). P PIN .Y I PIN. "Handbook For Claimants." T read this entire booklet immediatel . C :// . . . / / / O I .I , I R R Y VEC C C :// T T V . , E C . . . / . ? = & = . .T 711 711 PIN C .V E B " .C PIN. : U ID P .C PIN , 28 1-800-897-5630. TTY 1-866-241-9978. O - TTY 1-866-241-9978. I .L "F VEC I .F , NOW: / . . VEC' S R .

W E 120041512446 9100. W

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Filing Summar
General Information C I C F S N D : : : Eka120041512446c9100 01/05/2012 01/05/2012 10:33:41

Filing Eligibilit & Claim T pe 1. I

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: Yes
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VEC Claim for Benefits

2. What was the last date ou actuall performed work for an emplo er? 12/29/2011 3. Have ou had an active militar service since 07/01/2010? No 4. Have ou worked for the Federal Government as a civilian since 07/01/2010? No 5. Have ou worked in an other state, other than Virginia, since 07/01/2010? No Personal Information SSN: Full Name: Date of Birth: Confirmation email will be sent to Personal Information (con't) Gender: Race: Address: Cit /Count : Phone Number: VEC Field Office: Male White 1 Roberts Circle Poquoson VA, 23662 POQUOSON (757) 660 - 1041 Hampton XXX-XX-9280 JOSHUA L BROWN 03/29/1983 n/a

To resolve claim issues, sometimes it is necessar to contact ou b phone, if this is needed will ou require us to provide ou with an interpreter? No Filing Histor Have ou filed a claim for unemplo ment in Virginia since 07/01/2010? No Have ou filed a claim for unemplo ment in an state other than Virginia since 07/01/2010? No Last Occupation Last Occupation: SOC Code: Last Title: Most Recent Emplo er: Muller Martini Address: Did ou work at least 30 working da s for this emplo er? Did ou work at least 240 hours for this emplo er? Phone Number: Starting Date: Last Date Worked: Pa Rate: Number of hours worked each da of this week: Sunda 01/01/2012 0
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Industrial Machiner Mechanics 49904100

11850 Jefferson Avenue Newport News VIRGINIA, 23606 Yes Yes (757) 873 - 1234 06/14/2010 12/29/2011 $14.79 (Hourl )

Monda 01/02/2012 0

Tuesda 01/03/2012 0

Wednesda 01/04/2012 0

Thursda 01/05/2012

Frida 01/06/2012

Saturda 01/07/2012

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VEC Claim for Benefits

Sepa a ion Rea on: Wa o epa a ion d e o a di a e ? Pensions and Severance/Vacation/Holida Pa 1. Ha e o applied fo o a e o 2. Ha e o o 3. Ha e o o 4. Ha e o o ill o ill o ill o

Laid off/Reduction in Force No

ecei ing an kind of pen ion o Wo ke

Compen a ion? No

ecei e e e ance pa ? No ecei e aca ion pa ? No ecei e holida pa ? No

Other Information 1. Yo nemplo men benefi a e a able; do o an fede al income a benefi ( i hholding i 10% of benefi d e)? Yes 2. A e o a pe on i h di abili ? No 3. Ha e o 4. A e o 5. C o ked fo an ed ca ional in i ead , ion, p i a e o p blic, ince 07/01/2010? No illing, and able o accep FULL-TIME emplo men ? Yes i hheld f om o

en le el of ed ca ion: Attended college and/or Associate degree en l a ending chool/in aining? No and eligible fo efe al h o gh a nion hi ing hall? No n o o k da e ( o an emplo e ) on o befo e 02/12/2012? No

6. A e o c

7. A e o on he o -of- o k li 8. Do o ha e a defini e e 9. A e o c en l

o king pa - ime fo ano he emplo e ? No

10. Do o o n o ope a e o o n b ine , a e o an office of a co po a ion, a e o in ol ed in e ing p a b ine , o do o o n o ope a e a fa m? No 11. A e o filing hi claim f om a PC loca ed in a VEC Field Office? No

Your Benefits and Responsibilities:

Yo ill be held e pon ible fo hi info ma ion. Fail e o compl in a DENIAL of benefi . Yo ma i h o p in hi page. How do I get paid? Yo ill be paid ei he b di ec depo i o debi ca d. If o did no elec di ec depo i o ill ecei e a Vi ginia debi ca d in he mail i hin he ne 3-5 b ine da . Pa men fo eligible eek ill appea in he elec ed acco n i hin 2 b ine ( o king) da of filing o eekl claim. The debi ca d i good fo 3 ea . Addi ional cha ge appl fo a eplacemen ca d, o be e ha o ha e en e ed o name, ocial ec i n mbe , da e of bi h and mailing add e co ec l . What is a PIN? A Pe onal Iden ifica ion N mbe (PIN) ill be mailed o o once o claim i p oce ed. Plea e be e o ec e o pin a o ill need i o ce if o eekl claim fo benefi and hene e o con ac he VEC conce ning o claim. DO NOT LOSE THIS PIN. What is a separation issue? An ime o a e epa a ed f om o fo ce. emplo e fo ea on o he han a lack of o k o ed c ion in i h he e in c ion co ld e l

What is an able and availabilit issue?

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VEC Claim for Benefits

A .A What is a fact-finding interview? H O 10 .Y .B F What if I work for an educational institution and I am out of work due to a school break (summer, semester, or holida )? I . When is m claim effective? U Wh don't I get paid for the first week? T .H , .B . S . . . .S .Y .

You are required to do the following!

T (P .V E I .C ( N ) "F , S .Y (1-800-897-5630) PIN ").

1. Report all work (including temporar , part-time and self-emplo ment) and mone as it is earned ( / ) . E , , , .R / / .R , .I , . 2. Be able to work and available for suitable work . 3. If ou are required to be registered for Job Services . . . 5 . Failure to do so could result in denial of benefits. Y . N :I 5 . 4. Make an active search for work each week and report those job contacts on the Sunda , after the job contacts are made. Y (2) , .U (1) .I , , ,
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VEC Claim for Benefits

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Telephone contacts are not acceptable unless a telephonic application or interview is the onl method used b the emplo er. Y , .Y : 1. M 2. C 3. C 4. 5. 6. 7. Y W . Since the Virginia Unemplo ment Compensation Act requires that claimants provide the name of the emplo ers contacted for work, blind ads cannot be accepted. A blind ad is an ad in the newspaper that does not provide the emplo er name. Headhunters, web-based or otherwise, cannot be accepted for this same reason. For verification purposes, the Virginia Emplo ment Commission must have the prospective emplo er name to verif our contact. Print this confirmation now, then click the Job Service Registration button to continue. J S R F T T R , , ; , ; ; ; ( , , ; .). ! , P.O. B , , ; / 1 , VEC .Y

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