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Get IL ADJ034F 2011

Print Save State of Illinois Department of Employment Security www. ides. illinois. gov Work Search Record Claimant Information Last Name First Name MI ID or SSN Este es un documento importante. Si usted necesita un int rprete p ngase en contacto con su oficina local. Instructions Please use this form to keep a record of the work search efforts you made. Print Save State of Illinois Department of Employment Security www. ides. illinois. gov Work Search Record Claimant Information Last Name First Name MI ID or SSN Este es un documento importante. Si usted necesita un int rprete p ngase en contacto con su oficina local* Instructions Please use this form to keep a record of the work search efforts you made. Be sure that all requested information is provided* Failure to do so may result in a denial of benefits. If you need additional pages contact your local office or duplicate this form* Important Notice Keep Your Work Search Records A determination that you were actively seeking work during a week being claimed is subject to reconsideration despite the fact that you have been paid benefits or returned to work. In order to preserve evidence that you were actively seeking work do not discard your written work search record for any week being claimed until 53 weeks have passed from the end of that week. Further if there is an appeal pending regarding your active work search for a week keep your written work search record until there has been a final resolution of the matter. Click here for the Work Search Explanation* Week Ending Contact Date Name Address of Contact Person Contacted Method of Type of Work Sought Results ADJ034F Page 1 of 2 TCS-2 Rev* 09/2011 ID/SSN Name. Si usted necesita un int rprete p ngase en contacto con su oficina local* Instructions Please use this form to keep a record of the work search efforts you made. Be sure that all requested information is provided* Failure to do so may result in a denial of benefits. Be sure that all requested information is provided* Failure to do so may result in a denial of benefits. If you need additional pages contact your local office or duplicate this form* Important Notice Keep Your Work Search Records A determination that you were actively seeking work during a week being claimed is subject to reconsideration despite the fact that you have been paid benefits or returned to work. If you need additional pages contact your local office or duplicate this form* Important Notice Keep Your Work Search Records A determination that you were actively seeking work during a week being claimed is subject to reconsideration despite the fact that you have been paid benefits or returned to work. In order to preserve evidence that you were actively seeking work do not discard your written work search record for any week being claimed until 53 weeks have passed from the end of that week. In order to preserve evidence that you were actively seeking work do not discard your written work search record for any week being claimed until 53 weeks have passed from the end of that week. Further if there is an appeal pending regarding your active work search for a week keep your written work search record until there has been a final resolution of the matter. .

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