Deputy Payable
Resume:
UCB-** (R. **/**/****) (U*****)
or postmarked by:
appeal is received
Deputy Dated Decision final unless an
FINDINGS AND DETERMINATION OF THE DEPUTY:
Week Ending: Wisconsin Law:
Issue Week: Applicable
SS # UI Acct. #:
IMPORTANT INFORMATION Unemployment Insurance Division SEE REVERSE SIDE FOR Department of Workforce Development ID: 210165491 PAGE 1 OF 1 State of Wisconsin C FF141 UI LO #: 01
*387783189* 387 * 78 * 3189
DETERMINATION
ROBERT A REED
1227 N PLATTEN ST
GREEN BAY WI 54303-4323
08/21
02/20/21 108.04(11)
THE CLAIMANT CONCEALED WORK PERFORMED, WAGES EARNED, AND/OR A MATERIAL FACT ON HIS WEEKLY CLAIM(S) FOR WEEK(S) ENDING 02/20/21. THE CLAIMANT INDICATED:
- HE DID NOT HAVE A SEPARATION FROM EMPLOYMENT OTHER THAN A LAYOFF DUE TO LACK OF WORK. HE WAS SEPARATED FROM EMPLOYMENT WITH MARK GAJESKI CONSTRUCTION INC. FOR A REASON OTHER THAN A LAYOFF. DEPARTMENT RECORDS SHOW THE CLAIMANT AGREED THE ANSWER(S) GIVEN WAS/WERE TRUE AND ACCURATE TO THE BEST OF HIS KNOWLEDGE AND HAD THE OPTION TO CHANGE HIS ANSWER(S). THE CLAIM CONFIRMATION AND INSTRUCTIONS WERE ALSO SENT. IN ADDITION, A PRIOR CONCEALMENT DETERMINATION OR LETTER OF DIRECTION HAD BEEN SENT.
EFFECT
THE CLAIMANT'S BENEFIT AMOUNT SHALL HAVE A REDUCTION OF $648.00. THIS REDUCTION REMAINS IN EFFECT FOR BENEFITS AND WEEKS THAT BECOME PAYABLE DURING THE SIX-YEAR PERIOD THAT ENDS 05/22/27.
THIS BENEFIT REDUCTION OF FUTURE PAYABLE BENEFITS IS AN ADMINISTRATIVE PENALTY FOR INTENTIONALLY CONCEALING INFORMATION AFFECTING YOUR UNEMPLOYMENT ELIGIBILITY AND IS IN ADDITION TO ANY OVERPAYMENT CAUSED BY SUCH CONCEALMENT OF INFORMATION.
ADJUDICATOR 0174 05/25/21 06/08/21
See https://dwd.wisconsin.gov/uiben/services.htm for hours of operation. Employer name and location where the work was performed or fax.
determination regardless of whether you have been able to reach the department by telephone, mail, If you intend to appeal, you must file an appeal by the date stated on the front side of this UCB-20 (R. 08/28/2019) (U00243)
appeal. If you have any questions, refer to the online Handbook for Claimants at https://dwd.wisconsin.gov/uiben/handbook. If you are the claimant, you must continue to file weekly claims while this determination is under printing at https://dwd.wisconsin.gov/dwd/publications/ui/hearing.htm. Read all information carefully. When an appeal is filed, read the online booklet, Attending an Unemployment Insurance Hearing, available for viewing and DAYS PRIOR TO THE SCHEDULED HEARING.
IMMEDIATELY START PREPARING FOR A HEARING SINCE HEARING NOTICES MAY BE MAILED ONLY 6 determination will remain final.
review the reason and determine whether a hearing will be held or will dismiss the appeal without a hearing and the Appeals received or postmarked after the deadline must include a reason why you are filing late. The Appeal Tribunal will
* Claimant, employer or representative signature and date signed
* Any special needs such as an interpreter or other accommodations
* Dates and times when you and your witness(es) and/or representatives cannot attend a hearing
*
* Indication if it is a claimant or employer appeal
* Claimant name and social security number
* A copy of the determination or the 9-digit ID number located in the upper left-hand corner determination you want to appeal.
is a request for a hearing before the Appeal Tribunal. You must submit a separate request for each IF YOU DISAGREE WITH THIS DETERMINATION, YOU HAVE THE RIGHT TO FILE AN APPEAL. An appeal HOW TO FILE AN APPEAL
Assistance Line during business hours, or contact the department by mail or fax. If you have questions about employer charges or want to notify the department of an additional issue(s), contact the Employer FAX: 608-***-****
Menomonee Falls, WI 53052
Claimant Assistance Line: 414-***-****
P.O. Box 9001
Wisconsin Unemployment Help Center
the Claimant Assistance Line during business hours, or contact the department by mail or fax. This determination resolves an unemployment eligibility issue. If you have questions about this determination contact THIS INFORMATION IS IMPORTANT AND SHOULD BE READ IMMEDIATELY Madison, WI 53707
P.O. Box 7975
Madison Hearing Office
https://dwd.wisconsin.gov/ui/sides
Online:
Fax:
Mail:
Employer Assistance Line: 414-***-****
CLAIMANTS https://my.unemployment.wisconsin.gov
EMPLOYERS
WHERE TO FILE AN APPEAL
* Representative name and address, if you have one Filing by mail or fax include :
If filing by fax or online, your appeal must be received by midnight (Central Time). To be timely, your appeal must be received or postmarked by the last appeal date shown on the front of this determination.
Contact this candidate