Blank Hawaii Uc 253 PDF Form

Blank Hawaii Uc 253 PDF Form

The Hawaii UC 253 form is a vital document used by the Department of Labor and Industrial Relations to track job search efforts for individuals receiving unemployment benefits. This form, known as the "Record of Contacts Made for Work," requires claimants to detail their job search activities, including employer contact information and the outcomes of those interactions. Completing this form accurately is essential for maintaining eligibility for benefits, so be sure to fill it out carefully.

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The Hawaii UC 253 form is a vital document for individuals seeking unemployment benefits in the state. This form serves as a record of the job contacts made by claimants during their search for work. It is essential to accurately document each employer contacted, including their name, address, and phone number, as well as the method of contact—whether by phone, in person, or online. Additionally, claimants must note the position applied for and the outcome of each contact. This information is not only required during the continued claims process but is also subject to verification by the Unemployment Insurance Division. Completing the form accurately is crucial, as it helps demonstrate a claimant's active efforts to secure employment. Lastly, by signing the form, claimants affirm that the information provided is truthful, understanding that false statements can lead to penalties. Overall, the UC 253 form plays a significant role in the eligibility review process, ensuring that individuals remain compliant while navigating their job search during unemployment.

Document Sample

UC-253 (11/05)State of Hawaii

Department of Labor and Industrial Relations

UNEMPLOYMENT INSURANCE DIVISION

RECORD OF CONTACTS MADE FOR WORK

Record the contacts you made to obtain work that you reported on your continued claims. Please give this information to the interviewer during your Eligibility Review Interview or as requested. Your "Record of Contacts Made for Work" is subject to verification by the Unemployment Insurance Division.

Claimant's name

Social security number

Please provide the information requested or circle the appropriate response.

Date of

Employer's name, address & phone number

Method of

Name of person contacted

Position applied for

Applica-

Result of contact for

contact

 

contact

 

 

tion filed?

work

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OVER - CONTINUE YOUR RECORD OF JOB CONTACTS ON THE BACK OF THIS FORM

RECORD OF CONTACTS MADE FOR WORK - CONTINUED

Please provide the information requested or circle the appropriate response.

Date of

Employer's name, address & phone number

Method of

Name of person contacted

Position applied for

Applica-

Result of contact for

contact

 

contact

 

 

tion filed?

work

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify this information is true and correct to the best of my knowledge. I am aware the law provides penalties for false statements made for the purpose of obtaining benefits.

Claimant’s signature _____________________________________________________________________________

Date _________________________________________

File Specifics

Fact Name Fact Description
Form Title UC-253: Record of Contacts Made for Work
Governing Law Hawaii Revised Statutes, Chapter 383
Purpose This form is used to document job contacts made while claiming unemployment benefits.
Submission Requirement Claimants must provide this information during an Eligibility Review Interview or upon request.
Verification The Unemployment Insurance Division may verify the information submitted on this form.
Information Collected Includes employer details, contact methods, and results of job applications.
Signature Requirement Claimants must certify that the information provided is true and correct.
Consequences of False Information Penalties may apply for providing false statements to obtain benefits.

How to Use Hawaii Uc 253

Completing the Hawaii UC 253 form is essential for documenting your job search efforts. This information will be reviewed during your Eligibility Review Interview. Follow these steps to ensure the form is filled out correctly.

  1. Write your name and social security number at the top of the form.
  2. For each job contact, fill in the following details:
    • Date: Enter the date you made the contact.
    • Employer's name, address & phone number: Provide the full details of the employer.
    • Method of contact: Indicate how you contacted the employer (e.g., phone, in person, internet).
    • Name of person contacted: Write the name of the person you spoke with.
    • Position applied for: Specify the job title you applied for.
    • Application filed? Circle "Yes" or "No" to indicate whether you submitted an application.
  3. Repeat step 2 for each job contact you wish to report.
  4. Continue your record of job contacts on the back of the form, if necessary.
  5. At the bottom of the form, certify that the information is true by signing and dating it.

Your Questions, Answered

What is the Hawaii UC-253 form?

The Hawaii UC-253 form, also known as the Record of Contacts Made for Work, is a document that individuals must complete to track their job search activities while receiving unemployment benefits. It is essential for demonstrating compliance with state requirements for actively seeking employment.

Who needs to fill out the UC-253 form?

Anyone receiving unemployment benefits in Hawaii is required to fill out the UC-253 form. This form helps the Unemployment Insurance Division verify that claimants are actively looking for work, which is a condition for continuing to receive benefits.

How do I complete the UC-253 form?

To complete the UC-253 form, follow these steps:

  1. Fill in your name and Social Security number at the top of the form.
  2. For each job contact, provide the date, employer's name, address, and phone number.
  3. Indicate the method of contact (e.g., in person, by phone, or online).
  4. List the name of the person you contacted and the position you applied for.
  5. Note whether you filed an application and the result of the contact.

Ensure that all information is accurate and complete before submitting the form.

When do I need to submit the UC-253 form?

You should submit the UC-253 form during your Eligibility Review Interview or whenever requested by the Unemployment Insurance Division. Keeping this record up to date is crucial for maintaining your benefits.

What happens if I do not submit the UC-253 form?

Failure to submit the UC-253 form may result in a denial of unemployment benefits. The state requires proof of job search efforts, and not providing this information can lead to complications in your claim.

Can I use the back of the form to record additional contacts?

Yes, the UC-253 form includes space on the back for additional job contacts. If you have more contacts than can fit on the front, make sure to continue your record on the back to ensure all your efforts are documented.

Is there a penalty for providing false information on the UC-253 form?

Yes, there are legal penalties for providing false information on the UC-253 form. Claimants must certify that the information is true and correct. Misrepresentation can lead to serious consequences, including loss of benefits and potential legal action.

What should I do if I need help filling out the UC-253 form?

If you need assistance with the UC-253 form, consider reaching out to local unemployment offices or job assistance programs. Many organizations offer guidance on completing forms and navigating the unemployment process.

Where can I obtain a copy of the UC-253 form?

You can obtain a copy of the UC-253 form from the Hawaii Department of Labor and Industrial Relations website. It is also available at local unemployment offices if you prefer to fill it out in person.

How long should I keep my completed UC-253 forms?

It is advisable to keep your completed UC-253 forms for at least one year after submission. This documentation may be useful if there are any questions or disputes regarding your unemployment claim in the future.

Common mistakes

  1. Incomplete Information: Failing to provide all requested details can lead to delays or denials. Ensure that every section, including the claimant's name and social security number, is filled out completely.

  2. Incorrect Employer Details: Listing inaccurate employer names, addresses, or phone numbers can hinder verification efforts. Double-check the contact information for accuracy.

  3. Missing Dates: Omitting the dates of contact can create confusion regarding the timeline of job applications. Always include specific dates for each contact.

  4. Neglecting to Indicate Contact Method: Failing to specify how you contacted the employer (e.g., phone, in person, internet) may lead to questions about the legitimacy of the job search. Clearly indicate the method used for each contact.

  5. Not Signing the Form: Forgetting to sign the form can result in automatic rejection. Ensure that the claimant's signature is included along with the date.

  6. Providing False Information: Any inaccuracies or false statements can lead to serious legal repercussions. It is crucial to certify that all information is true and correct to the best of your knowledge.

Documents used along the form

The Hawaii UC-253 form is a vital document for individuals applying for unemployment benefits in Hawaii. It serves as a record of job contacts made while seeking employment. Along with the UC-253, there are several other forms and documents that may be required during the unemployment claims process. Here is a list of commonly used forms and documents.

  • UC-1 Form: This is the initial application for unemployment benefits. Claimants provide personal information, employment history, and the reason for unemployment.
  • UC-2 Form: This form is used to report weekly unemployment claims. It includes questions about job searches and earnings during the week.
  • Eligibility Review Interview Notice: This document informs claimants of their scheduled interview to assess eligibility for benefits. It outlines what information to prepare.
  • Employer Response Form: Employers may be asked to complete this form to verify a claimant's employment history and the reason for separation from the job.
  • Work Search Log: This is a detailed record of job search activities. It may include dates, employers contacted, and methods used to apply for jobs.
  • Resume: A current resume may be required to demonstrate job-seeking efforts. It outlines the claimant's work history, skills, and qualifications.
  • Identification Documents: Claimants may need to provide identification, such as a driver's license or Social Security card, to verify their identity.
  • Tax Documents: Recent tax returns or W-2 forms may be requested to confirm income levels and employment history.
  • Appeal Form: If a claim is denied, this form is used to formally appeal the decision. It outlines the reasons for the appeal and any supporting evidence.

Each of these documents plays a crucial role in the unemployment claims process. Being prepared with the necessary forms can help streamline the application and review process, ensuring that claimants receive the benefits they are entitled to.

Similar forms

The Job Search Record is similar to the Hawaii UC 253 form as it serves to document the efforts made by an individual to find employment. This form typically requires the claimant to list employers contacted, dates of contact, and the methods used, such as phone calls or in-person visits. Like the UC 253, the Job Search Record may be reviewed by an unemployment office to verify claims and ensure that individuals are actively seeking work. This documentation is crucial for maintaining eligibility for unemployment benefits.

The Employment Verification Form also shares similarities with the UC 253. This document is used to confirm employment status and job search activities. Claimants must provide details about their job applications, including employer contact information and the positions applied for. Both forms emphasize the importance of accurate reporting and may lead to penalties if false information is provided. The Employment Verification Form helps to maintain the integrity of the unemployment benefits system.

The Weekly Claim Certification Form is another document that resembles the Hawaii UC 253. This form is submitted weekly by claimants to report their job search activities and eligibility for benefits. It includes sections for detailing job contacts and any earnings received during the week. Like the UC 253, the Weekly Claim Certification Form requires claimants to provide truthful information, as discrepancies can lead to disqualification from receiving benefits.

The Job Application Log is also comparable to the UC 253 form. This log is a personal record maintained by job seekers to track their applications, interviews, and follow-ups with potential employers. It typically includes the same types of information as the UC 253, such as employer details and application outcomes. Keeping a Job Application Log can help individuals stay organized and demonstrate their job search efforts if required by unemployment agencies.

Finally, the Reemployment Services Eligibility Assessment (RSEA) form is akin to the Hawaii UC 253. This document is used during assessments to evaluate a claimant's job search activities and readiness for reemployment. It collects similar information regarding contacts made and positions applied for. The RSEA is crucial for identifying any additional support or services that may be needed to assist individuals in their job search, ensuring they remain compliant with unemployment requirements.

Dos and Don'ts

When filling out the Hawaii UC 253 form, it is important to follow certain guidelines to ensure accuracy and compliance. Here are five things you should do and five things you should avoid.

  • Do provide accurate information. Make sure all details, such as your name and social security number, are correct.
  • Do list all contacts made for work. Include every employer you reached out to, along with their contact information.
  • Do indicate the method of contact. Specify whether you contacted the employer by phone, email, or in person.
  • Do keep a copy of the form. Retain a copy for your records in case you need to reference it later.
  • Do sign and date the form. Your signature certifies that the information is true and correct.
  • Don't leave any sections blank. Fill out all required fields to avoid delays in processing your claim.
  • Don't provide false information. Misrepresentation can lead to penalties or denial of benefits.
  • Don't forget to follow up. If you do not receive a response from an employer, consider reaching out again.
  • Don't use informal language. Keep your responses professional and straightforward.
  • Don't rush the process. Take your time to ensure all information is complete and accurate.

Misconceptions

Here are eight common misconceptions about the Hawaii UC 253 form:

  • The UC 253 form is optional. Many believe this form is not necessary, but it is essential for documenting job search efforts when filing for unemployment benefits.
  • Only online job applications count. Some think that only online applications are valid. In reality, any method of contact, including in-person and phone calls, is acceptable.
  • Submitting the form guarantees benefits. Completing the UC 253 does not guarantee that benefits will be approved. The information provided is subject to verification.
  • Information on the form is not confidential. Many assume that their information is public. In fact, the details are kept confidential by the Unemployment Insurance Division.
  • All job contacts must result in an application. It is a misconception that every contact must lead to a formal application. Even inquiries without applications are valid contacts.
  • You can submit the form at any time. Some believe they can submit the UC 253 whenever they wish. However, it must be provided during the eligibility review interview or as requested.
  • Only one form is needed for multiple job contacts. Individuals often think they can list multiple contacts on one form. Each contact should be recorded separately to ensure clarity.
  • Falsifying information on the form is harmless. Some may think that providing inaccurate information is inconsequential. However, it can lead to penalties and denial of benefits.

Key takeaways

Filling out the Hawaii UC-253 form is an essential step for individuals seeking unemployment benefits. Below are key takeaways to consider when completing and utilizing this form.

  • Accurate Record Keeping: It is crucial to maintain a detailed record of all job contacts made during your claim period. This includes the date, employer's name, contact information, and the method of contact.
  • Verification Process: The information provided on the UC-253 form is subject to verification by the Unemployment Insurance Division. Ensure that all entries are truthful and can be substantiated.
  • Eligibility Review Interview: Present the completed UC-253 form during your Eligibility Review Interview. This form serves as a key document to demonstrate your active job search efforts.
  • Multiple Contact Methods: Utilize various methods for contacting potential employers, such as in-person visits, phone calls, and online applications. Document each method accurately on the form.
  • Signature and Certification: Before submitting the form, remember to sign and date it. By doing so, you certify that the information provided is correct to the best of your knowledge, acknowledging the legal implications of false statements.