Pennsylvania Flex Time Request Form

State:
Multi-State
Control #:
US-AHI-175
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is filled out by an employee who would like to request a new flexible time schedule.
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How to fill out Flex Time Request Form?

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FAQ

Potential Mutualization means that your employment circumstances are a result of a mutual agreement between you and your employer.

PA Employer UC Account Number This seven-digit number is shown on the New Employer Confirmation Letter (Form UC-1408), Notice of Pennsylvania Unemployment Compensation Responsibilities (Form UC-851), and the Contribution Rate Notice (Form UC-657).

If an employer is granted a relief from charges, the Department will remove charges that are included in the relief determination. No further charges will be applied to the employer. If an employer is granted a relief from charges, it should not have any impact of the Claimant's UC Benefit status.

Flextime is an arrangement that allows an employee to alter the starting and/or end time of her/his workday. Employees still work the same number of scheduled hours as they would under a traditional schedule. It is also a flexible work option for positions that do not easily support remote work.

A new Pennsylvania law (Act 9 of 2020) requires Pennsylvania employers to provide notice to employees about unemployment compensation benefits at the time of separation from employment or when an employee's work hours are reduced.

A request for relief from charges must be filed by the LAST DATE FOR TIMELY REQUEST indicated on Form UC-44FR to be timely. If a request is faxed to the department, the filing date is the date of receipt indicated by the department's fax machine. or send a Fax to 717-724-6952.

The Unemployment Compensation (UC ) program provides temporary income support if you lose your job through no fault of your own or if you are working less than your full-time hours. If you qualify, you will receive money for a limited time to help you meet expenses while you seek new employment.

From the Department of Labor According to the Department of Labor, "an employer may change an employee's work hours without giving prior notice or obtaining the employee's consent (unless otherwise subject to a prior agreement between the employer and employee or the employee's representative)."

This form is used by NON-TPA's to change an employer's UC benefit's address. UC-1609 (PDF): Employer Information Form Size=153k You must provide this completed form to separating employees and/or employees working reduced hours. It provides accurate information for use when unemployment claims are filed.

If the employer does not reply to the Unemployment Compensation office within the time allowed, the Unemployment Compensation office will move forward with a determination and will base the eligibility for unemployment compensation benefits on the information before it, which is typically the information provided by

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Pennsylvania Flex Time Request Form