Helpside Unemployment Case Questionnaire
In most states, unemployed individuals are entitled to payment for a limited period if they become unemployed through no fault of their own. Individuals are not entitled to receive unemployment benefits in situations where the employer can prove that the employee voluntarily quit without good cause or where the employee was terminated for deliberate or criminal conduct that was contrary to the employer's rightful interests. This form collects information we need to dispute your former employee's unemployment claim. Please fill out the form completely and with as much detail and facts as possible.

If you choose to not respond in a timely manner or do not include all requested information, the state will proceed with the available information, potentially resulting in an unfavorable decision.

We are here to help.  Please contact us if you have questions.

--Your Helpside HR Team
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Email *
Please note: Although there are 31 total sections as part of this guide, you will NOT see or need to fill out every single section.
What is the full name of the employee we contacted you about? *
If your company has two or more employees with this name, please provide the last 4 digits of their SSN as well.
When was their termination date? *
MM
/
DD
/
YYYY
If the termination is different from the last date worked, what is the date of the last day worked? *
Or type "same" if the dates are not different
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