Get Dws-ui Form 669 Rev - Jobs Utah

Filling out the DWS-UI Form 669 Rev is an essential step for anyone seeking to notify their employer of a wage assignment due to a grievance. This guide will provide you with clear, step-by-step instructions to complete the form accurately and efficiently online.

Follow the steps to fill out the DWS-UI Form 669 Rev online.

1. Click the 'Get Form' button to access the form and open it in your preferred online editor.
2. In the first section, enter your name and Social Security number (S.S.N.) in the appropriate fields to identify yourself.
3. Provide the name of the employer from which you have been terminated, ensuring to include any relevant details if applicable.
4. Insert the name of the separating supervisor. This is the individual who was responsible for your termination.
5. Fill in the address of the employer, including the street address or P.O. Box.
6. Indicate the date of your separation from the employer for proper documentation.
7. Complete the city, state, and zip code of the employer's location.
8. Enter the Utah or Federal Employer Account number to facilitate identification and processing.
9. Provide the employer's telephone number for contact purposes.
10. Confirm your intention to file a grievance by indicating whether you have filed or intend to file a grievance for reinstatement.
11. Acknowledge your claim for unemployment insurance benefits and the assignment of wages you may receive during the grievance period.
12. Authorize the employer and the Utah Department of Workforce Services to share necessary information to fulfill the wage assignment requirements.
13. Sign and date the form to validate your submission.
14. After completing the form, review your entries for accuracy. You can then save your changes, download, print, or share the form as needed.

Complete your DWS-UI Form 669 Rev online today to ensure your grievance process is properly documented.