Family Services Insurance Operations
Resume:
IF YOU HAVE ANY QUESTIONS, IMMEDIATELY CONTACT YOUR LOCAL ODJFS PROCESSING
CENTER BY CALLING THE TELEPHONE NUMBER IDENTIFIED ABOVE. CORRESPONDENCE ID: 000************ CLAIMANT ID: 000************ DSN: 006646
NOTICE: JI81N1
PSN: 006646
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Claimant's Name Social Security Number
Benefit Year Beginning Date Benefit Year Ending Date Date Mailed Return to:
OHIO DEPARTMENT OF JOB AND FAMILY SERVICES
OFFICE OF UNEMPLOYMENT INSURANCE OPERATIONS
NOTICE OF ELIGIBILITY ISSUE
DRAKE S. WORTHY ***-**-****
06/02/2024 05/31/2025
JFS-82200 11/10/2016
07/02/2025
Application Date
06/23/2025
IMPORTANT INFORMATION - DEADLINE FOR REPLY: 07/10/2025 Cleveland Adjudication Center
PO Box 182212
Columbus, OH 43218
Phone: 877-***-****
Fax: 614-***-****
DRAKE S. WORTHY
3956 ANDRUS AVE
COLUMBUS, OH 43227
Claimant Id
1004159
At least one issue has been raised which could stop your unemployment benefits. If the issue raised is a quit, discharge, refusal of work, refusal of a referral, or a false statement to obtain benefits, your benefits may be stopped for the duration of your unemployment. You must provide information about each issue within five business days. If you fail to respond by the deadline date, ODJFS will make a decision based on available information.
On 06/16/2025, the following eligibility issue was raised: Reporting requirements - Reporting requirements; the source of the issue is continued claim; this issue may affect your unemployment benefits beginning on 05/18/2025. The deadline date for your response is 07/10/2025.
You have the right to review all of the information concerning the above continuing eligibility issue(s), including any documents in your file, and/or those presented at a fact-finding interview. To arrange to review these documents, telephone the ODJFS office number identified above. On the following page(s), you will see questions about each issue displayed above. To respond to this request for information or to provide additional information, you may:
* Complete and mail or fax this form to the ODJFS office address or fax number identified above.
* Telephone the ODJFS office at the phone number identified above.
* Or for expedited service, log onto the ODJFS Claimant Self-Service website at https://unemployment.ohio.gov and click on the section entitled "Correspondence Inbox." This option is not available after the deadline date.
ODJFS will use information received by the deadline date to decide if you will continue receiving benefits. The agency's decision, called a Determination of Unemployment Compensation Benefits, will notify you in writing whether your benefits are reduced or disallowed, and for which week(s). You may also request a fact-finding interview. You must request a fact-finding interview by the deadline date by mail, fax, or by calling the telephone number identified above. If you respond to fact- finding questions on our website https://unemployment.ohio.gov, you may include your request for a fact-finding interview in any of the response fields. The office identified above must receive your request by the deadline date. If requested timely, the office will schedule the interview. You can bring witnesses, documents, or other information to the fact-finding interview. All information you provide by the end of IF YOU HAVE ANY QUESTIONS, IMMEDIATELY CONTACT YOUR LOCAL ODJFS PROCESSING CENTER BY CALLING THE TELEPHONE NUMBER IDENTIFIED ABOVE. CORRESPONDENCE ID: 000************ CLAIMANT ID: 000************ DSN: 006646
NOTICE: JI81N1
PSN: 006646
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the fact-finding interview will be considered.
PLEASE NOTE: You may continue to receive benefit payments for the week(s) at issue. If you receive benefits for any weeks that are later reduced or disallowed, you will receive a Determination of Benefits reducing or disallowing the week(s), and informing you how much you are overpaid. You must repay that overpaid amount or future benefits will be withheld until the overpayment has been repaid. IF YOU HAVE ANY QUESTIONS, IMMEDIATELY CONTACT YOUR LOCAL ODJFS PROCESSING CENTER BY CALLING THE TELEPHONE NUMBER IDENTIFIED ABOVE. CORRESPONDENCE ID: 000************ CLAIMANT ID: 000************ DSN: 006646
NOTICE: JI81N1
PSN: 006646
Page 3 of 4
THIS SPACE FOR OFFICIAL USE ONLY
Si usted no puede leer esto, llame por favor a 1-877-***-**** para una traduccion. Claimant's Name
DRAKE S. WORTHY
Claimant Id
1004159
Social Security Number
***-**-****
Reporting requirements - Reporting requirements
Issue Raised
05/18/2025
Issue Start Date Benefit Year End Date
05/31/2025
A1002D182E0066462028G
Return Mail Instructions:
After you complete this form, please mail it to the RETURN ADDRESS or fax it to the FAX number listed to the right of this block.
If using the provided envelope, please make certain that the RETURN ADDRESS information is clearly visible in the envelope's window before sealing.
CONTACT INFORMATION:
Phone: 877-***-****
Fax: 614-***-****
RETURN ADDRESS:
Cleveland Adjudication Center
PO Box 182212
Columbus, OH 43218
Fact-Finding Questions for Reporting requirements - Reporting requirements issue involving DRAKE S. WORTHY, (***-**-****).
1. Did you read instructions regarding filing timely weekly claims that you received on your "New Claim Instruction Sheet" and in your "Workers' Guide to Unemployment Compensation"? A. If yes, did you understand these instructions?
2. If you did not understand the instructions regarding filing timely weekly claims for benefits, did you try to contact the agency for an explanation?
IF YOU HAVE ANY QUESTIONS, IMMEDIATELY CONTACT YOUR LOCAL ODJFS PROCESSING CENTER BY CALLING THE TELEPHONE NUMBER IDENTIFIED ABOVE. CORRESPONDENCE ID: 000************ CLAIMANT ID: 000************ DSN: 006646
NOTICE: JI81N1
PSN: 006646
Page 4 of 4
THIS SPACE FOR OFFICIAL USE ONLY
Si usted no puede leer esto, llame por favor a 1-877-***-**** para una traduccion. Claimant's Name
DRAKE S. WORTHY
Claimant Id
1004159
Social Security Number
***-**-****
Reporting requirements - Reporting requirements
Issue Raised
05/18/2025
Issue Start Date Benefit Year End Date
05/31/2025
A1002D182E0066462028G
A. If yes, please describe your attempt(s) to contact the agency, including the dates on which your attempts were made.
3. Please explain why you did not file your weekly claim for benefits in a timely manner as instructed. 4. Please provide any additional information about this issue. 5. Do you want this agency to issue a determination based on the information you have provided in this response? If no, any further information that you wish to provide must be received by your processing center by the deadline date on this notice.
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