Dws Ui Form 617 B PDF Details

In navigating the complexities of the legal system, particularly within the framework of unemployment claims, the necessity for representation can, at times, become paramount. Within this context, the DWS-UI 617B form emerges as a critical document for those within the State of Utah. This form, specifically designed by the Department of Workforce Services Appeals Unit, serves as a petition for the approval of claimant’s non-attorney representation fees. Its primary purpose is to ensure that individuals seeking representation in unemployment insurance appeals are allowed to have their representatives' fees reviewed and approved by an administrative law judge. This process, meticulously outlined within the form, requires detailed documentation from the representative, including the duration and nature of services provided, total expenses incurred, and the total fee requested. Furthermore, it mandates transparency and adherence to established caps on representation fees, as outlined in department rule R994-508-201(2), which generally prohibits approval of fees exceeding 25% of the claimant’s maximum unemployment entitlement. The form also emphasizes the rights of claimants, allowing them the opportunity to object to the fee within a specified period and underscoring the penalties for any violation of the outlined regulations. Designed to balance the scales of justice by ensuring reasonable and equitable fees for representation, the DWS-UI 617B form plays a crucial role in safeguarding the interests of those navigating the oft-complex arena of unemployment appeals. By providing a structured platform for the assessment and approval of representation fees, it ensures that claimants are not unduly burdened financially in their pursuit of rightful unemployment benefits.

QuestionAnswer
Form NameDws Ui Form 617 B
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other names new york state department of labor unemployment insurance division claim service subsection 2016-2019 form

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DWS-UI 617B Rev. 11/2016

State of Utah

Department of Workforce Services

Appeals Unit

PETITION FOR APPROVAL OF CLAIMANT’S NON-ATTORNEY

REPRESENTATION FEE

Claimant’s Name:

 

 

Claimant’s SS Number:

 

Date(s) of Hearing:

 

 

Appeal Case Number:

 

Date Retained:

 

 

 

Date Representation Ended:

 

Total Amount of Expenses/Fees PAID by Claimant to date: $

Total Fee (including any pre-paid amount) Requested: $

DATE

ITEMIZED SERVICE

(i.e. research, preparation of appeal, attendance at hearing)

ACTUAL TIME

REQUIRED

I certify that the above information and the information provided in response to the questions on the second and third pages of this form is true and correct to the best of my knowledge.

Printed Name of Representative

Signature of Representative

Representative Telephone Number

Representative’s email address

Street Address or P.O. Box

City, State, Zip Code

Make sure all pages of this form are completed and provided to the administrative law judge. Return the completed form to the Appeals Unit by mailing it to PO Box 45244, Salt Lake City, UT 84145-0244, by FAX to 801-526-9242, or by email to dwsappeals@utah.gov. Department rule R- 994-508-202 requires that prior to the administrative law judge approving the fee, a copy of this petition must be mailed to the claimant and the claimant is allowed ten days from the date of mailing to object to the fee.

The approval or disapproval of a fee rests solely with the administrative law judge. Department rule R994-508-201(2) generally prohibits the approval of fees in excess of 25% of the Claimant’s

maximum unemployment entitlement. The fee decision will become final unless within ten days from the date of issuance of the approved fee letter, further written appeal is made to the Appeals Board, P.O. Box 45244, Salt Lake City, UT 84145-0244, setting forth grounds upon which the appeal of the fee is made.

Section 35A-4-103(3) . . . Any individual claiming benefits in any proceeding before the department or its representatives or a court may be represented by counsel or any other duly authorized agent; but no counsel or agent shall either charge or receive for his services more than an amount approved by the department. Any person who violates any provision of this subsection shall, for each offense, be fined not less than $50 nor more than $500 or imprisoned for not more than six months, or both.

Before the petition for fees will be considered, the following questions must be answered:

1.In your opinion, why was representation advisable or necessary at the hearing: (Include, e.g., any complexity or novelty of facts of issues.)

2.Was the alternative of self-representation explained to the Claimant?

Why was this option rejected?

3.What fee, if any, was agreed to for your services?

4.On what basis was the agreed fee, if any, calculated?

5.What fee is customarily charged in your locality for representation and what is the basis for that fee?

6. What is the amount and nature of your experience:

In unemployment insurance appeals?

In other administrative appeals?

7.Is the fee sought reasonable and equitable given the Claimant’s circumstances and, if so, why?

Equal Opportunity Employer Program

Auxiliary aids and services are available upon request to individuals with disabilities by calling (801) 526-9240. Individuals

with speech and/or hearing impairments may call Relay Utah by dialing 711. Spanish Relay Utah: 1-888-346-3162.

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Dws Ui Form 617 B conclusion process described (stage 1)

2. Right after this selection of fields is done, proceed to type in the suitable information in these: I certify that the above, Printed Name of Representative, Representatives email address, Street Address or PO Box, City State Zip Code, Make sure all pages of this form, and The approval or disapproval of a.

Filling in section 2 in Dws Ui Form 617 B

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Ways to fill in Dws Ui Form 617 B part 3

Always be really attentive when filling out What fee if any was agreed to for and Was the alternative of, because this is where a lot of people make mistakes.

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The best way to fill out Dws Ui Form 617 B part 4

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Ways to complete Dws Ui Form 617 B stage 5

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