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The New York Labor Unemployment form, specifically designed for Shared Work benefits, plays a crucial role in helping employees navigate the complexities of reduced work hours while still maintaining their financial stability. This form is divided into two main parts: the Employee Statement and the Employer Statement. In the Employee Statement, individuals must provide essential information such as their name, Social Security number, and details about their work status for the week they are claiming benefits. They are asked to answer specific questions regarding any additional work they may have undertaken, their earnings, and their employment status with their Shared Work employer. Meanwhile, the Employer Statement requires employers to confirm the percentage of hours and wages reduced due to Shared Work, along with details about the employee’s separation from the company, if applicable. Both parties must ensure that the information provided is accurate, as any discrepancies can delay the processing of benefits. Completing this form correctly is vital for employees to receive the support they need during times of reduced work hours, and it also ensures that employers comply with state regulations regarding unemployment insurance.

Similar forms

The New York Labor Unemployment form shares similarities with several other documents related to unemployment benefits and employment verification. Here are four documents that are comparable:

  • Unemployment Insurance Claim Form: This form is used by individuals to apply for unemployment benefits when they are fully unemployed. Similar to the New York Labor Unemployment form, it requires personal information, work history, and a declaration of availability for work. Both documents serve to establish eligibility for benefits based on employment status.
  • Weekly Certification for Unemployment Benefits: This document is completed weekly by claimants to confirm their unemployment status. Like the New York Labor Unemployment form, it asks about any work performed during the week and requires the claimant to affirm their eligibility. Both forms are designed to ensure that individuals receive benefits only when they meet specific criteria.
  • Employer Verification Form: Employers often need to fill out a verification form to confirm an employee's work status and earnings. This is similar to the employer section of the New York Labor Unemployment form, which requires employers to provide information about reduced hours and the reasons for any employee separations. Both forms aim to verify the accuracy of claims made by employees.
  • Shared Work Program Application: This application is used by employers to enroll in a program that allows them to reduce employee hours while providing partial unemployment benefits. Like the New York Labor Unemployment form, it involves both employer and employee information and is designed to facilitate the sharing of work among employees during economic downturns.

Form Preview

New York State Department of Labor

Unemployment Insurance Division

Shared Work Continued Claim

Waiting Week Certification

(Instructions on second page)

Claimant name (print):

 

 

 

 

 

SSN

 

 

 

 

If your name has changed since you last certified, print your previous name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part A – Employee Statement

Waiting Week

 

(Sunday Week

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ending Date)

Enter the date and answer the questions for the week claimed:

 

 

 

1. Did you work for anyone other than your Shared Work employer on any day in the week? (This includes

Yes

No

self-employment.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If “Yes,” complete “a” through “c.”

 

 

 

 

 

 

 

 

 

a. How many days did you work? 1

2

3

4 or more

 

 

 

b. Excluding earnings from self employment, did you earn more than $405 during the week? Yes No

 

 

 

c. Are you still working for this employer?

 

Yes

No

 

 

 

If No, complete the questions below.

 

 

 

 

 

 

 

 

 

i.What was your last day of work with this employer? ___/___/___

ii.What is the reason you are no longer working for this employer?

Quit

Discharged

Lack of Work

Labor Dispute

iii.Employer’s name and address: ______________________________________________

_____________________________________________________________________________

Claimant Certification: I claim Shared Work benefits under the New York State Unemployment Insurance Law. I certify that the above statements are true and complete, that I was partially unemployed, able to work, available for work with my Shared Work employer and that my loss of wages was due to no fault of mine. I have not claimed Unemployment Insurance benefits under any other State or Federal system for this period nor will I receive any other payment (i.e., Sub Pay) to compensate me for this period. I realize the Law prescribes penalties for false statements.

Signature:

 

Date:

 

Address (complete only if changed):

 

 

 

Part B – Employer Statement

For the week claimed:

 

 

 

 

 

 

1.

Enter the percent of hours and wages that were reduced due to Shared Work.

__________%

 

(Note: Vacation, holiday and sick pay are considered “employment” for the purpose of calculating the

 

 

 

percent reduction. See second page for details.)

 

 

 

 

 

2. Did the employee leave the company?

 

 

 

Yes

No

 

If “Yes,” please indicate the reason for separation and the employee’s last day of work:

 

 

 

 

Quit

Discharged

Lack of Work

Labor Dispute

 

 

 

 

Last day of work: ___/___/___

 

 

 

 

 

3.

Did the employee refuse any work made available to him/her during the hours he/she was scheduled off

Yes

No

 

due to Shared Work?

 

 

 

 

 

 

 

If “Yes,” number of days refused work: _ 1

2

3

4 or more

 

 

4.

Did you permanently shut down your company?

 

 

 

Yes

No

 

If “Yes,” what was the date the company was permanently closed: ___/___/___

 

 

 

 

 

 

 

 

 

 

 

I certify that the above information concerning the status of this company and the status/earnings of this employee for the purpose of participating in the Shared Work Program is true and correct to the best of my knowledge.

-

Employer account no.Employer nameEmployer signature

98-

Locator code (if any)

Date

Employer telephone number

SW 4.1 (10/13)

Shared Work Continued Claim

Part A - Instructions to Employee

This form is used to claim Shared Work benefits during a week(s) in which your normal hours of work were reduced according to a Shared Work Plan agreed to by your employer.

Complete Part A, “Employee Statement,” on the other side of this form. New York Unemployment Insurance benefit weeks run from Monday through Sunday. Be sure to show the Sunday week ending date(s) for the week(s) you wish to claim in the space provided at the top of the form.

If your name has changed, print your correct name and your previous name in the space provided at the top of the form.

If you have changed your address, print your new address in the space provided below your signature. Be sure to include your zip code.

Return this form to your employer, who will complete Part B and send it to the Department of Labor for processing.

Part B – Instructions to Employer

The purpose of this form is to confirm the status of employees you have listed in your Shared Work Plan.

The percent reduction is calculated by dividing the number of hours for which the employee was not paid due to work sharing by the number of hours normally worked in a week.

Shared Work benefits are not available for time that is paid for by the employer to the employee. That is, all time for which the employee receives compensation from the employer is considered “employment” for the purpose of calculating the percent reduction. This includes vacation, holiday and sick pay as well as payment for services performed.

Example: Employee’s normal schedule is 40 hours a week, 8 hours a day. Employer is shut down on Friday due to Shared Work.

a.Employee works Monday through Thursday: this is a 20% reduction.

b.Employee works Monday through Wednesday, gets paid sick leave for Thursday, is off Friday due to shutdown: this is a 20% reduction.

c.Employee works Monday through Thursday and gets holiday pay for Friday: this is a 0% reduction.

Give one form to each employee covered by your Shared Work Plan on the Monday following the latest Sunday week ending date on the reverse of the form, or as soon as possible thereafter if the employee is not working on Monday. This will be the second Monday after the date your Shared Work Plan becomes effective and every other Monday thereafter.

After the employee completes Part A and returns the form to you, complete Part B, “Employer Statement,” and send it to: NYS Department of Labor, Unemployment Insurance Division, Attention - Shared Work, PO Box 621, Albany, N.Y. 12201-0621. Send it within seven (7) days of the latest week ending date shown on Part A.

Mail the forms for all of the employees together in one envelope, if possible.

If you have a NY.GOV ID, you can send the forms by using the messaging feature after you log into your Unemployment Insurance Online Services account.

If the employee completed Part A and wishes to claim the week, submit the form for our review and determination even though you protest payment. Include a statement explaining why you protest the payment.

Review the completed form to be sure that it is correct.

Any errors or omissions will cause a delay in payment of benefits.

If you have questions, contact the Shared Work Unit at (518) 485-6375.

Common mistakes

Filling out the New York Labor Unemployment form can be a straightforward process, but many people make common mistakes that can lead to delays or denials of benefits. One frequent error occurs when individuals fail to provide accurate information about their employment status. For instance, if someone worked for another employer during the week but does not disclose it, they risk being penalized for providing false information. It is essential to answer the question regarding outside employment truthfully and completely.

Another mistake is not properly indicating any name changes. If a claimant has changed their name since their last certification, they must provide both their current and previous names. Omitting this detail can cause confusion and hinder the processing of the claim. Claimants should always ensure that their names are consistent with official documents to avoid complications.

Claimants also often overlook the importance of the waiting week certification. This section requires individuals to confirm that they were partially unemployed and available for work. Failing to accurately complete this part can lead to misunderstandings about eligibility. It is crucial to ensure that all statements are true and complete, as inaccuracies can lead to penalties under the law.

Finally, many people neglect to check their earnings from self-employment. The form specifically asks if claimants earned more than $405 during the week. If they do not report this correctly, it may affect their benefits. Claimants should carefully review their earnings and ensure that they provide accurate figures to avoid issues with their claims.

More About Ny Labor Unemployment

  1. What is the purpose of the New York Labor Unemployment form?

    The New York Labor Unemployment form is designed for individuals participating in the Shared Work Program. It allows employees to claim benefits when their hours have been reduced due to a Shared Work Plan implemented by their employer. The form consists of two parts: Part A, which is completed by the employee, and Part B, which is filled out by the employer. This process helps ensure that employees receive the appropriate benefits while documenting their work status.

  2. How does an employee complete Part A of the form?

    To complete Part A, the employee must provide their name, Social Security Number (SSN), and any previous names if applicable. They need to enter the week ending date for the claim and answer questions regarding their work status during that week. This includes detailing any work done for other employers, earnings, and whether they are still employed by the Shared Work employer. The employee must also certify the accuracy of their information by signing the form.

  3. What information does the employer need to provide in Part B?

    In Part B, the employer must indicate the percentage of hours and wages reduced due to Shared Work. They also need to confirm whether the employee left the company, the reason for separation, and the employee’s last day of work. Additionally, the employer must disclose if the employee refused any work during their scheduled off hours. This section ensures that the Department of Labor has a complete understanding of the employee's work situation.

  4. What happens if the employee has changed their name or address?

    If the employee has changed their name since the last certification, they should print their previous name on the form. Additionally, if there has been a change of address, the employee should provide the new address in the designated space below their signature. This information is crucial for maintaining accurate records and ensuring that any correspondence regarding their claim is sent to the correct location.

  5. How should the completed form be submitted?

    After the employee completes Part A, they must return the form to their employer. The employer will then fill out Part B and submit the entire form to the New York State Department of Labor. It is important that this submission occurs within seven days of the latest week ending date indicated on Part A. Employers can also use online services to submit the forms electronically if they have a NY.GOV ID.

Misconceptions

Misconception 1: The NY Labor Unemployment form is only for full-time employees.

This form is applicable to both full-time and part-time employees who are part of a Shared Work Plan. Any employee whose hours have been reduced can use this form to claim benefits.

Misconception 2: You cannot claim benefits if you worked for another employer during the week.

Claimants can still qualify for benefits even if they worked for another employer, as long as they meet the earnings threshold and other requirements outlined in the form.

Misconception 3: The waiting week certification is optional.

The waiting week certification is a mandatory part of the claims process. Claimants must complete this section to verify their eligibility for benefits.

Misconception 4: You can only receive benefits if you are fully unemployed.

The Shared Work program is designed for individuals who are partially unemployed. Employees can receive benefits while still working reduced hours.

Misconception 5: You cannot change your address on the form.

Claimants are encouraged to update their address if it has changed. There is a designated space on the form for this purpose.

Misconception 6: Employers do not need to complete Part B of the form.

Part B must be completed by the employer to confirm the employee's status and the extent of hours reduced due to Shared Work.

Misconception 7: You will automatically receive benefits once you submit the form.

Submission of the form does not guarantee benefits. Each claim is reviewed for accuracy and eligibility before benefits are disbursed.

Misconception 8: All forms submitted are processed immediately.

There may be delays in processing due to errors or omissions. It is important to ensure that all information is accurate to avoid delays.

Misconception 9: The Shared Work program is only available for certain industries.

The Shared Work program is available to a wide range of industries in New York State. Any employer with a valid Shared Work Plan can participate.

Key takeaways

Key Takeaways for Filling Out and Using the New York Labor Unemployment Form:

  • The form is essential for claiming Shared Work benefits when your hours are reduced.
  • Fill out your name and Social Security Number accurately at the top of the form.
  • If your name has changed, provide both your current and previous names.
  • Specify the Sunday week ending date for the week you are claiming benefits.
  • Answer all questions in Part A, particularly regarding any additional work you performed.
  • Confirm your employment status with your Shared Work employer when answering questions.
  • Part B must be completed by your employer; they will submit it to the Department of Labor.
  • Return the completed form to your employer promptly for processing.
  • Be aware that vacation, holiday, and sick pay count as “employment” when calculating hours worked.
  • Submit the form within seven days of the week ending date to avoid delays in benefits.

Ny Labor Unemployment: Usage Guide

After gathering all necessary information, you are ready to fill out the New York Labor Unemployment form. Follow these steps carefully to ensure accurate completion. Once filled out, the form will need to be submitted to your employer, who will complete their section before sending it to the Department of Labor.

  1. Print your name and Social Security Number (SSN) at the top of the form.
  2. If your name has changed, write your previous name in the designated space.
  3. In Part A, enter the Sunday week ending date for the week you are claiming benefits.
  4. Answer the question about whether you worked for anyone other than your Shared Work employer during the week. Mark Yes or No.
  5. If you answered Yes, provide details by completing sections a, b, and c:
    • In section a, indicate how many days you worked (1, 2, 3, or 4 or more).
    • In section b, state if you earned more than $405 during the week (Yes or No).
    • In section c, confirm if you are still working for this employer (Yes or No).
  6. If you answered No in section c, provide the following information:
    • What was your last day of work? Write the date.
    • State the reason you are no longer working for this employer (Quit, Discharged, Lack of Work, or Labor Dispute).
    • Fill in the employer’s name and address.
  7. Sign and date the Claimant Certification section, confirming that your statements are true.
  8. If your address has changed, complete the address section below your signature.
  9. Return the completed form to your employer.

Once your employer receives the form, they will fill out Part B and send it to the Department of Labor for processing. Ensure that all information is accurate to avoid delays in your benefits.