Form 54244 PDF Details

In navigating the complexities of unemployment insurance claims, the State Form 54244 emerges as a pivotal tool for employers within Indiana. Functioning under the auspices of the Indiana Department of Workforce Development, this form, termed the Unemployment Insurance Protest (Employer), offers a structured method for employers to dispute unemployment claims. The nuances of this form are manifold, addressing the need for disclosing the claimant's Social Security Number—a requisite tied to regulatory mandates. Its design caters to various scenarios including but not limited to layoffs, changes in company ownership, severance, and instances of discharge for cause among others. Importantly, the form encourages the use of SIDES (State Information Data Exchange System), a digital conduit for streamlining the exchange of information pertinent to unemployment insurance claims. Amid the procedural specifics, the form underscores the gravity of timely responses to inquiries from the UI Adjudication Center, hinting at potential penalties for delayed or non-compliance. By providing a detailed pathway for contesting unemployment claims, the State Form 54244 is integral to ensuring that both employers' and claimants' perspectives are thoroughly considered within the adjudication process.

QuestionAnswer
Form NameForm 54244
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesstate 54244 640p, state form 54244 640p, protest form workforce, protest form 640p

Form Preview Example

UNEMPLOYMENT INSURANCE PROTEST (EMPLOYER)

State Form 54244 (R5 / 2-17), DWD 640-P

INDIANA DEPARTMENT OF WORKFORCE DEVELOPMENT

CONFIDENTIAL RECORD PURSUANT TO IC 22-4-19-6, IC 4-1-6

RECEIVE AND PROTEST UI CLAIM NOTICES

ELECTRONICALLY with

SIDES (State Information Data Exchange System)

For more information and to register visit

in.gov/dwd/sides.htm

*This agency is requesting the disclosure of the claimant's Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Claimant

 

 

 

 

Social Security Number

Benefit Year End

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claimant Street Address, City, State and ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

Indiana SUTA (Employer Account Number)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer Address, City, State and ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employee worked from:

 

to last day worked:

 

 

 

 

mm/dd/yyyy

 

 

 

 

 

 

mm/dd/yyyy

 

Brief Statement of Facts

regarding separation:

NOTE: If the claimant is separated due to Layoff, Lack of work or the assignment ending, you do not need to complete

this form or protest the claim.

Claimant never worked here OR unable to locate this claimant. (Code 52827)

Change of ownership/Predecessor-Successor/Out of business. (Code 527)

Agent no longer represents this company. (Code 52227)

Former PEO client OR Successor after a merger / acquisition. (Code 527)

Reason for Separation (choose one):

 

 

 

Quit - (Code 10)

 

Discharge for Cause - (Code 20)

 

Gross Misconduct - (Code 30)

 

Availability - (Code 70)

 

Failed/Refused Drug Test - (Code 30)

 

Employment Status - (Code 70)

 

Still Employed - (Code 70)

 

School Worker - (Code 70)

Work Refusal or Failed Pre-employment Drug Test - (Code 70) Did the claimant receive income upon separation or thereafter? - (Code 70)

Include specific information in statement section and/or attach documents to this submission.

Vacation

Severance

Sick

Personal

Pension/401k

Wages

Other

Please note: You will receive additional requests from the UI Adjudication Center seeking specific details concerning the employee's separation. Please respond to these requests as quickly as possible. Failure to respond to requests from the department can result in a penalty, even if the employee is later determined ineligible.

Contact Name of Employer

 

Date

 

 

 

 

 

mm/dd/yyyy

Signature of Employer

 

 

Telephone

 

Check here if you are attaching additional supporting documents to this fax, total number of additional pages:

Fax Form to: UI Adjudications at 317-233-5499

How to Edit Form 54244 Online for Free

The purpose powering our PDF editor was to allow it to be as simple to use as possible. The whole process of filling in form 54244 indiana hassle-free once you follow the next actions.

Step 1: At first, pick the orange "Get form now" button.

Step 2: After you access the form 54244 indiana editing page, you will find each of the actions it is possible to take about your template in the top menu.

To create the file, provide the details the system will request you to for each of the appropriate segments:

state form 54244 640p indiana fields to fill out

You have to note the essential details in the Reason for Separation choose one, Quit Code, Discharge for Cause Code, Gross Misconduct Code, Availability Code, FailedRefused Drug Test Code, Employment Status Code, Still Employed Code, School Worker Code, Work Refusal or Failed, Did the claimant receive income, Vacation, Severance, Sick, and Personal space.

Filling out state form 54244 640p indiana stage 2

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