Para Tate

Location:

Posted:

June 27, 2021

Resume:

IMPORTANT! The following information is needed to determine if you can be paid unemployment benefits. It is critical that you understand the information in this document. If a question does not apply, state that in your answer. There is room at the bottom to add more information, if necessary. Complete and submit this questionnaire no later than 6/25/2021. If returned by mail, your response must be received no later than 6/25/2021. If you do not respond by the due date, we will issue a decision based on the available information. If you need help understanding or with the translation of the information in this document, call 1-800-***-****.

IMPORTANTE! La siguiente información es necesaria para determinar si se le puede pagar beneficios de desempleo. Es sumamente importante que usted comprenda la información de este documento. Si una pregunta no aplica, declare que no aplica en su respuesta. Si es necesario, hay espacio en la parte inferior para añadir más información. Complete y envíe este cuestionario antes del 6/25/2021. Si se lo devuelve por correo, su respuesta debe recibirse a más tardar el 6/25/2021. Si no responde para la fecha de vencimiento, emitiremos una decisión basada en la información disponible. Si necesita ayuda para comprender o con la traducción de la información de este documento, llame al 1-800-***-****. Employment Information

Employer Name: VAIL CORP

DBA Name: VAIL ASSOCIATES INC

Address Line 1: PO BOX 283

Address Line 2:

City: SAINT LOUIS

State: Missouri

ZIP/Postal Code: 63166-0283

Employment Start Date: 12/11/2018

Employment End Date: 5/26/2021

Job Title: SALES AND RELAT

IMPORTANTE: Este documento afecta su elegibilidad para recibir beneficios de Seguro de Desempleo. Si usted no entiende este documento, llame inmediatamente a la lÃnea de servicio al cliente del Departamento de Trabajo y Empleo de Colorado al 1-800-***-****.

45165960

An Equal Opportunity Employer Page 1 of 3

Division of Unemployment Insurance

P.O. Box 400

Denver, CO 80201-0400

Go online: coloradoui.gov

Call: 1-800-***-****

Fax: 303-***-****

Forwarding Service Requested

Sara E. Reaves

c/o TATE E REAVES

3525 S Cherokee St #18 June 24, 2021

Englewood, CO 80110-3523 Claimant ID: 13232471

Section 1

1. Did your employer contribute to the pension/retirement benefit? If yes:

1a. Was your pension/retirement paid in one lump sum or in a series of payments? If Lump Sum:

• What was the date you received the pension/retirement payment?

• What was the amount of pension/retirement you received, before taxes? $

• How did you receive the pension/retirement payment? (Check, direct deposit, etc.) If Payments:

• What is the beginning date of the pension/retirement payments?

• What is the amount before taxes of each payment? $

• How often will you receive each payment?

Weekly

Every two weeks

Monthly

Twice a month

Other; explain:

1b. Indicate what you intend to do with the pension or retirement pay: I do not intend to reinvest. I understand that if I choose not to reinvest my lump-sum pension or retirement, UI benefits will be postponed from the date of receipt of the payment for the number of weeks equal to the total amount of the pension divided by the full-time weekly wage received from the employer.

I will reinvest the money into a KEOGH or Individual Retirement Account (IRA) for duration of at least one year. I understand that I must provide proof of reinvestment to UI Operations that the entire sum was reinvested. I must provide such proof within 14 calendar days of the effective date of my claim or within 60 calendar days of receipt of the payment, whichever is later. I have already reinvested the money into a KEOGH or Individual Retirement Account (IRA) for at least one year. I understand that I must provide proof of reinvestment to UI Operations that the entire sum was reinvested. I must provide such proof within 14 calendar days of the effective date of my claim or within 60 calendar days of receipt of the payment, whichever is later. Yes

Lump Sum

Payments

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If you wish to provide any additional information about this issue, provide below. _Name and title of __the person completing this request: _Telephone number of __the person completing this request: If you would like to be contacted by email as an additional method to contact you, please provide your email address:

I certify that the above information is true and correct and I understand that the law provides penalties for false information.*

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