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ALPHABET ONLY. ONE LETTER ONLY. DATE IN MM/DD/YYYY FORMAT.9ALL CAPS. ALPHABETS ONLY. MUST NOT EXCEED 30 CHARACTERS.COPTIONAL. ALL CAPS. ALPHABETS ONLY. MUST NOT EXCEED 30 CHARACTERS. Male FemalePAmerican Indian/Alaskan Native Asian African American Pacific Islander Caucasian'Not Hispanic / Latino Hispanic / Latino Yes No@ALL CAPS. NO SPECIAL CHARACTERS. MUST NOT EXCEED 40 CHARACTERS. ALL CAPS. 2 LETTER STATE CODE. MAIN 5 DIGIT ZIP CODE.!OPTIONAL. 4 DIGIT PLUS4 ZIP CODE. MAILING ADDRESS RESIDENTIAL ADDRESS2Yes No IF NO, PLEASE PROVIDE RESIDENTIAL ADDRESS. State / Province Alcorn Amite Attala Benton Bolivar Calhoun Carroll Chickasaw Choctaw Claiborne Clarke Clay Coahoma Copiah Covington Desoto Forrest Franklin George Greene Grenada Hancock Harrison Hinds Holmes Humphreys Issaquena Itawamba Jackson Jasper Jefferson Jefferson Davis Jones Kemper Lafayette Lamar Lauderdale Lawrence Leake Lee Leflore Lincoln Lowndes Madison Marion Marshall Monroe Montgomery Neshoba Newton Noxubee Oktibbeha Panola Pearl River Perry Pike Pontotoc Prentiss Quitman Rankin Scott Sharkey Simpson Smith Stone Sunflower Tallahatchie Tate Tippah Tishomingo Tunica Union Walthall Warren Washington Wayne Webster Wilkinson Winston Yalobusha Yazoo<REQUIRED IF MS RESIDENT. PLEASE SELECT COUNTY FROM THE LIST.ePlease carefully read the instructions for each column. Columns with asterisk sign are required.79 DIGIT SSN WITH NO DASHES OR SPACES. 999999999 FORMAT.&Are you receiving an employer pension SSN * First Name * Middle Initial * Last Name * Date of Birth * Gender * Race * Ethnicity * Are you a U.S. citizen? * Telephone Number * Address Line 1 * Address Line 2 * City * State / Province * ZIP Code * 2 Is residential address same as mailing address ? *1 -MUST BE 10 DIGIT NUMBER IN 999-***-**** FORMAT. Adams" Mass Layoff Employer Instructions Mississippi Department of Employment Security (MDES) is here to help employers with your Mass Claim filing. To start the process, you will need an Excel Employee template. Export employee information into the Excel Employee template and start the process Staff identified in the Bullet Exception List below will need to file online at www.mdes.ms.gov, using our Fillable Form claim process, or by calling the MDES Contact Center at 1-888-***-****. Bullet Exception ListG Those who have worked for the military in the last 18 months F Q Those who have worked for the federal government in the last 18 months P C Those who have worked out of state in the last 18 months B Non US citizens ) You are now ready to start the process. Z Press: Control and then click on the link below, or copy and paste it into your browser 4 B Once you have completed your employee template, access the link and click upload https://upload.mdes.ms.gov/dropzone/21691c30 For steps 1 through 6 below: After the employer completes the upload process, the employer will email the information to MDES at: **********@****.**.*** . The system will automatically capture your contact information once it is uploaded Steps 1 through 6 h 1 Employer Account Number(s): EAN; Provide Federal Employer ID Number (FEIN) if EAN is unknown $ p 2 Mass Layoff Effective Date Must start with Sunday). Sunday begins the start day for a benefit week 3 Mass Layoff End Date: (Must end with Saturday). Saturday of the last day of the claim week before employees return to work 6 Please note: The return date may be difficult to define under the current situation. Choosing a date in June, for instance, does not commit your layoff to extend that long. zAfter the mass claim is completed, it is very important for employers to communicate the requirements to their employees These requirements are 1 Create a user id and password at www.mdes.ms.gov R 2 File your weekly certifications each week: There are two ways to file Frequently Asked Questions QPress Control and click on the FAQ links below for both employees and employers. 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