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I SSUES" TW
NS T0
VZO STATE OF WASHINGTON UC REG
EMPLOYMENT SECURITY DEPARTMENT UC
UCx FE FSC ?
DETERMOINAT ION NOTICE
SSN D t0 V
JSC I BYE O I
, s
r
r
p DECISION: In accordance with RCW 50. d 0• d??d / l) of the Revised Code of Washington
r (see attached) and on the basis of your statement and aver ab a records, it is here?bpy determined that you
('.C) .( Yd At. Cr ?y>J-rQ_.? f ,%/.t..J? '
r
ACCORDINGLY:
f? Benefits are allowed beginning with the week ending if otherwise eligible.
-c-
Benefits are denied:
? one day ? two days ? one week ending
beginning Jd•¢Af. i -._/ .i .3d r / y,P' /sF0 4?4? and until you have obtained bona
J
fide work and earned wages of not less than your weekly benefit amount in each of five weeks;
? or until you report IN PERSON to the Department in each of ten calendar weeks.
? a definite period beginning week ending through week ending
? an indefinite period for the week(s) ending
and until you are ready, able and
willing Iwediately to accept any offer of suitable work and are actively seeking work.
? beginning with the week ending and until you have been employed at least
four weeks with a total remuneration earned of not less than four times S
ti 1
? OVERPAYMENT ASSESSMENT: Benefits paid as shown on the attached Schedule of Claim Reports constitute an over-
payment (pursuant to RCW 50.20.190) for which you are liable.
APPEAL NOTICE
This Determination Notice/Overpayment Assessment is final unless an appeal is filnd In person with any Joh Service
Certer or bes taa rked to The Office of Administrative Hearings, 5000 Capitol Boulevard, Olympia, Washington 90509
or before
EMpt YER / DELI RY/MAILING oSire Cii n^',+ 30???5
P . /Jn r `/7.f C Y BY IBC. n /u_t UFl""'"lfJ"_
1 ?fU /Y4?'!?i fi^'C? f Y #,?N?15$ i. 4 "', YiW ?9 SP M l L
4
u
Y 9??,
? t t a; ? t .
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5
37 ,:115 ;T;
SUMMARY OF EMPLOYMENT SECURITY LAWS (RCW 50.)
NOTICE: The language set forth below is intended to be the general context of the cited law. You may obtain a
.
copy of the complete law from your Job Service Center upon request. E
Ap,
a. RCW 50.04.310. UNEMPLOYED INDIVIDUAL. An individual shall be deemed to be "unemployed" in any week during which
h no renumeration is payable to the individual or in
hi
t
?.>:
, to w
c
the individual performs no services and with respec
if the remuneration payable with respect to such week is less than one and
s than full-time work
f l
k =.
,
es
o
any wee
one-third tines the weekly benefit amount plus five dollars.
^$y RCN 50.04.323. PENSION REDUCTION. The weekly benefit amount payable to an individual shall be reduced by the
revious work of such individual, if such pa
t based on the
i
,.j`l_
p
on paymen
entire prorated weekly amount of any pens
lan maintained or contributed to by a base year employer, and (except Social Security and Rail-
der a
i
f 'y1
? p p
s un
ment
road Retirement) the services performed during the base year affect eligibility for or increase the amount o
contributions made by the individual for
b g`y
j
,
ase-year
such payment. The amount of reduction shall take into account
the pension.
U
t^'
RCN 50.20.010. BENEFIT ELIGIBILITY CONDITIONS. An unemmployedindividual shall be eligible to receive waiting
week in tAhe individual's eligibility period only if the Commis-
ect to an
s
ith ,
y
p
re
period credit or benefits w a
- sioner finds that:
(1) the individual has registered for work, and thereafter has continued to report at an Employment Office
in accordance with prescribed regulation;
(2) the individual has filed an application for an initial determination end made a claim for waiting period
a
i?., credit or for benefits;
(3) the individual is able to v ci-an available for work. To be available for work an individual must
be offered and must be actively
k which ma
bl
i + -
$ ?-
w
r y
e wor
ta
be ready, able, and willing, matey to accept_ any su
seekin work pursuant to c emery trade practices and through other methods when directed;
gg
period of one week; and
ed fora wait g
lo
unem
b
,
p
y
een
) th e individual s
(4
meets the conditions of ROW 50.22.020 for benefits
emod
efit
d be
d
,
p
n
e
(5) the individual, during an exten
f twen -six tines the individual's weekly benefit amount.
i
!tii
n excess o
claimed
R 50.20.060. DI TION FOR VOLUNT Y UNEMPLOYMENT DUE TO MISCONDUCT. An individual
nn a endar week in which the individual has left work volun-
m bene its beg
d f
lifi
. i
ro
e
shall be disqua
e or has been dischar suspended for misconduct connected with the work, and there-
d
i
7 caus
thout goo
tarily w
after until the individual has obtaine na fide work and earned wages of not less than the suspended weekly
ach of five calendar weeks. An individual who has left work as a result of marital status or
t i
b
i ,
F;74
- n e
t amoun
y
benef
domestic responsibilities may clear the disqualification either by returning to work as ]ust described or,
individual is
t th
th
i
e
a
ng
orting in person to the department during ten different calendar weeks and certify
ood cause for
re
h ;
? p
g
able, and wtllmngto accept suitable work and is seeking work. An individual
ready
because of the
fide
t
,
na
J
voluntarily leaving continued employment if the reason for leaving was to accep
of the claimant or because of the death, illness or disabill of the immediate
t
di
bil
'
y
sa
i
illness or
family. Also considered is the degree of risk to the indiviual's health, safety and morals. Alcoholism shall
d
t
i ?l$
t scon
uc
.
not constitute a defense to disqualification from benefits due to m h,
4 RCW 50.20.060(2). CRIMINAL MISCONDUCT. An additional penalty may be applied if an individual is discharged
This disqualification takes effect if the
work
h th
d
i
.
e
w
t
because of a felony or gross misdemeanor connecte
individual Is convicted or admits committing the criminal act and serves to delete all wage credits earned prior - ,,
to the discharge. a - -'
ROW 50.20.010 DISQUALIFICATION FOR MISREPRESENTATION. An individual shall be disqualified for benefits with
false statement or representation involving a
d V i
} e a
respect to any week to which the individual has knowingly ma
material fact and has thereby obtained or attempted to obtain any
t
a
material fact or knowingly failed to repor
benefits under the provisions of this title. ""bbY
a ROW 50.20.080. DISQUALIFICATION FOR REFUSAL TO WORK. An individual is disqualified for benefits, if the endive-
dual has failed without good cause to apply for available, suitable work when so directed or to accept suitable
individual has obtained work and earned wages
til th {LY'
•?`
'
xr e
work when offered. Such disqualification shall continue un
h of five weeks
t i , W
.
n eac
therefore of not less than the individual's suspended weekly benefit amoun
RCW 50.20.090. LABOR DISPUTE DISQUALIFICATION. An individual shall be disqualified for benefits for any wee
issioner finds that the individual's unemployment is due to a stoppage of work
C
th k
omm
e
with respect to which
cause of a labor dispute at the factory, establishment, or other premises at which the individual
i
t
f the
i
h
b
i
s
ex
s
e
on o
wh
c
Is or was last employed; PROVIDED. That this section shall not apply if it is shown to the satisfact
Commissioner that:
(1) the individual is not participating in or financing or directly interested in the labor dispute which
k
d
f
p
r
n , an
wor
caused the stoppage o
(2) the individual does not belong to a grade or class of workers of which inmediately before the commence-
any of when are
h the stoppage occurs
hi
t ,;7)
,
w
c
mint of the stoppage, there were members employed at the premises a
articipating in or financing or directly interested in the dispute; PROVIDED, That in any case separate branches
onducted n separate de-
i ?y?
,''S?'t
p
ses are c
of Work which are canmonly conducted as separato businesses in separate prem
be doomed to be
ose of this subdivision
th F
,
e purp
partments of the same promises, each such department shall, for r y,.
a separate factory, establishment or other premises.
EMS 5344 (Rev.10/04)
,o
mim i...
,r
Page 2
.? r
5
. u. RCM 50.20.095. Any individual registered at an established school in a course of study providing scholastic in-
struction of twelve or more hours per week, or the equivalent thereof, shall be disqualified frog receng
benefits or waiting period credit for any week during the school term commencing with the first week of such
scholastic instruction or the week of leaving employment to return to school, whichever is the earlier, and
ending with the week immediately before the first full week in which the individual is no longer registered for twelve or more hours of scholastic instruction per week: PROVIDED, that registration for less than twelve hours
will be for a period of sixty days or longer. The term "school" includes primary schools, secondary schools, and
"institution of higher education" as that phrase is defined in RCN 50,44.037.
1:>?°
?+ ?•+
S
_ a r
Y5A..
-
e
•.-`".•' The disqualification shall not apply to any individual who:
(1) Is in approved training within the meaning of RCW 50.20.043; or
(2) Demonstrates to the commissioner by a preponderance of the evidence his or her actual availability for
work, and in arriving at this determination, the commissioner shall consider the following factors:
e
-ellx?
- (a) Prior work history;
(b) Scholastic history
(c) Past and current labor market attachment; and
(d) Past and present efforts to seek work. ''
t -
--? • ,i:
" ?yh J?h
SV 9nns
?z a
RCW 50.20.130. DEDUCTION FROM WEEKLY BENEFIT AMOUNT. If an eligible individual is available for work for less
than a full week, he shall be paid his weekly benefit amount reduced by one-seventh of such amount for each day
i
i '' -:
that he
s unava
lable for work: PROVIDED, That if he is unavailable for work for three days or more of a week, t
he shall be considered unavailable for the entire week.
Each eligible individual who is unemployed in any week shall be paid with respect to such week a benefit in an
amount equal to his weekly benefit amount less seventy-five percent of that part of the remuneration (if any) -.` -
:-
"
payable to him with respect to such week which is in excess of five dollars
Such benefit
if not a multiple of
Y .
-
?
.
,
one dollar, shall be reduced to the next lower multiple of one dollar.
RCM 50.20.190. OVERPAYMENT ASSESSMENT. An individual who is paid any amount of benefits under this title to -
which he or she is not entitled shall, unless otherwise relieved pursuant to this section, be liable for repay-
ment of the amount overpaid. All overpayment assessments can be the basis for judicial or adninistrative pro-
ceedings to satisfy the assessment without further notice. '.;
RCW 50.22.020. ELIGIBILITY FOR EXTENDED BENEFITS. Payment of extended compensation shall not be made to any
individual for any week of unemployment if the individual:
(1) fails to accept any offer of suitable work or fails to apply for suitable work when directed; or vR, ,:,yy
&
Y
(2) fails to actively engage in seeking work. - ,
The disqualification does not end until the individual has been employed during at least four weeks which begin
after such failure and the total of the remuneration earned by the individual for being so employed is not less
than 4 times the individual's weekly benefit amount.
No provisions of this title which terminate a disqualification for a marital or domestic quit, shall apply unless
such termination is based upon employment subsequent to the date of such disqualification.
RCW 50.22.030. EXTENDED BENEFIT ELIGIBILITY CONDITIONS--INTERSTATE CLAIMS. (1) An individual shall be eligible
to receive extended benefits with respect to any week of unemployment in his or her eligibility period only if
the commissioner finds with respect to such week that:
(a) The individual is an "exhaustee" as defined in RCM 50.22.010;
(b) He or she has satisfied the requirements of this title for the receipt of regular benefits that are
applicable to individuals claiming extended benefits, Including not being subject to a disqualification for the
receipt of benefits; and
(c) He or she has earned wages in the applicable base year of at least forty times his or her weekly benefit
amount.
(2) An individual filing an interstate claim in any state under the interstate benefit payment plan shall not be
eligible to receive extended benefits for any week beyond the first two weeks claimed for which extended benefits
are payable unless an extended benefit period embracing such week is also in effect in the agent state.
ROW 50.44.050. EMPLOYEES IN AN EDUCATIONAL INSTITUTION. Benefits based on services in an instructional,
research or principal administrative capacity or any other capacity for an educational Institution shall not be
paid to an individual for any week of unemployment which commences during the period between two successive
academic years or terms if such an individual performs such services in the first of such academic years or terms
and If there is a contract, reasonable assurance, or an individual written notice to the employee that the indi-
vidual will perform such services in the second of such academic years or terms. These provisions also apply to
educational service district employees who perform such services in an educational Institution.
Benefits shall not be paid for an week of unemployment which commences during an established and customary vaca-
tion period or holiday recess if such Individual performs services immediately before such vacation period or
holiday recess, and there is a reasonable assurance that such Individual will perform services in the period
Immediately following such vacation period or holiday recess.
EMS 5344 (Rev.10/84)
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11
L
,
Department of the Ireaeury
' Internal Revenue Service
Date:
9? 10_29-84 8442
9101 91-0I-17-17 s
w
?p To:
COUNTY OF JFFFERSo., c
% PATRICIA 1'1 KNAPi,
PORT rowrl5[rln, uA /63.I,
..? 4_ ,_.
?k
?r Y
Request for Infora,atiorf from Employer (To locate person)
We are trying to locatu the per,.;:1 Haan,.: h,alow ann would appr uclote your help. We certify that the information asked for
is required for ottirlal bu+an; ,,. 1 .e '111- ,rxla-.111i td' ;thor appropriate sources for getting the information.
Please lurnish the
1. Indicate it presently amp. -, ad :,r ? Yes 'ems N0
It Yes. skip items 2, h, an... oeu.,,
2, If no longer employed h)' .,u. If - .:.,;e amployment endeo. 0y ??-
3. Home address, it ditlerew I.om nn- cne shown: 7076 i(
4. Telephone number:,U6 76 2;""3-2 S>/
5. Social security number, it :?,nercct horn the one:,hown:
7. Any other information Ih,o ;,,u r.e,-; may nulp us Ioc,av Ims person; or the name, address, and telephone number
of anyone who may know .. nun: t„ oc,ou this persun.
6. Name, address, and tele{, -no I.,,,uer of present employer, of known.
Please return this form in Inr ndlusi,u ,velupe. No posl..ge is needed.
Thank you for your cooper.;:,.
Person's Name and Addna:.
BAUMUNK, ALLAfI J
PO BOX 564
1"HIMACOM, WA 9d32i
Return this form to.
INTERNAL REVS IUE SI. '.?I<I
915 SFrOfJD AVENUE, :.mi. 1. IU
SEATTLE, WA 'IFf174
Cnn:l, Collection Branch
SOCIAL SECURITY NUMBER
538-42-9560
,-.- 3242-C m., ,alas,
,
, ?N4? We are trying to locate the person named in section A
below and would appreciate your.telp. Plea inplete
section B and return the form to us. We certhat
the information asked for is required for official
,?, business and that we have exhausted all other
'T appropriate sources for getting the information.
x?il
- Thank you,
Director
_ .. ..r.. Internal Revenue Service
?lF !Oc•r;,Nr end mail portion Below-no postage necessary)
d v
Form 3242 Departmental the Treasury-Internal Revenue Service
JR.,April 1982) Request for Information from Employer (to Locate Person)
f, _ - I Date of this request
1542 536-42-9560 0CT301984
Q
c Last known address
?
0
Social Security Number LAUliUL::, ALL;dl J ZIP Code
20 nu;: 564
J;:II Us?Ufl, WA 96325
Please check the appropriate box or show the current address below according to your records.
Same address as above 11 Unknown
Number Street Telephone number
" 2C ?.L/L'_A= d 4? ?, /
I a10(o) G.S-'V
Current atldress City State ZIP Code
r m
rling)
a
a
lFrfid h1l ,then rtapte of the rep t
?
?
?
_
__ __
Indicate if presently employed uy you. - El yes tl - Date employment ended
If yes, do not complete the renmhtder of this form. 09? a-??
c
0
• Name
U
Numt; r Street Telephone Number
Present employer
(if known) ( )
City State ZIP Code
Any other information that may help us locate this person, or the name, auuress ants tempnune numuer m anyurw wnu moy
know where to locate this parson;
45
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Form 3242(Rav.A• ? '
f
c rt
? 4 $ 1?s4,L 1?'M Ff< ^?ci', r'FfH ..
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STATE OF WASHINGTON - EMPLOYMENT SECURITY DEPARTMENT IMANT - DO NOT WRITE IN THIS BOX •y,.
K
NOTICE TO EMPLOYER ,
da.nenfl Name _36+--??
J3D 3 ' r Dye
.Y
?
'
At weraed under Sure of Rwon
.y m•f der of c1 E toy«
±
?9
U
? INSTRUCTIONS TO EMPLOYER r
`
employment was Jg?
3
R
, ra_ nw
ie.. THIS INDIVIDUAL HAS FILED A CLAIM FOR •I'
' S
,L .y
i A yYS [- tA? 1' FQi4 lO
_
F
L:i UNEMPLOYMENT BENEFITS NAMING YOU AS
HIS/HER LAST E _
,
Ary wwf u,o a.ak At -
_
p
J MPLOYER. PLEASE
COM- PLETE THE REVERSE SIDE OF THIS FORM AND
RETURN IT
14H emed as . AS SOON AS POSSIBLE OR NO
?"f5
t 1 LATER THAN TEN (10) DAYS FROM
+ I became w«wtoyw beuw.
IF YOU AGREE THAT THE REASON FOR SEPA-
RATION IS "LACK OF WORK
"
T
S
+'
9
,
I
I
NOT
NECESSARY TO RETURN +
THIS FORM.
The U.S. Supreme Court has hold that once. decision Is made
_ ekowYp benefits. IM claimant 4 entkNd to the
prompt
me s of ben.m. even ttn
n th
th
k
ded
Mm
,r+i'
p 1
r
.. t up
e wt
yer .pp
-
e
alone To Inwn proper determination of .ipbYity, please err-
nl.h ate Department with . d.retl.d fact" statement of the
n3
.FBI {
;'I
?
y ..
.epY.Ilat. h de.Dsanpa al = .Ply Wormaflonyou,tfle . . repay nom kt claenkn wemM
oa
at.rmNw on tha bap ope
F ? }
,
",J•. ,
BUSINESS NAME AND ADDRESS OF MY LAST EMPLOYER of wemgloym.nt Is ~ than "Lack of Wa k" err k you
Mw
Informatwn to queeigo tho claimant. sapbwy for
bee fits, I,
yi
xv • . x
PA 0 -Q so G u u
10 .5 ` : rJ
and Yen Men to be pm.ent when de appausnt Is McMwad 4s
reoardna the spent loa er,"fibiity.:chock appropriate block
'
va : ' {
A pa
ra nwas eke. and you will be Informed of the time ant place k':•
of klfervlew. HgWvY, vote w riot. (puked to adand much a
pmmadim and may rThaat wrlttw Marmetlon w fth will be
olven fee eonsroentice n rmakbo the dstarmlautba of Nabi•
try. Yam cooperAtloo =V help to PM"M ngrop.f POYmsa/a
of benelpa ro loo ats!gvd to your fapoan.
-•EYSdIEt• tt/art.' ?-OltMioa - ro
EMPLOYER'S STATEMENT OF CLAIMANT'S SEPARATION
Clentent's last day of work was 9/28 IG84 462.40
aed prow earning. lot that calerder week ware •
Cteknard was separated on 9/28 11184 Rat. of pry war 0 11.34 Par hr. Y#... '.
pW.IpaY/wKIIM).) Y
Job title was Equ L pment Operator REASON FOR SEPARATION: -Lack of work -Discharge X Oull -Other
It other than lack of work, piasee give full delall? Alan Baumunk tendered hLs wrLtten resLgnatLon be- a
cause ho wanted to pursue self-empLoyment opportunLtLes.,
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List any actions a demands which cause You to believe the individual I. not seriously attached to the labor market w facts which may affect eligibility such as T
sell-employment. i 10,848 kdury, school attendance, subsequent employment.
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If discharged. was claimant w adrleed when given teperatmn nouce7 -Yes _No II Yes, by when
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,Y PLEASE CHECK IF PERTINENT: -1 wish to be present when the olalmant Is
Intervlewed regarding the separation. yI vv,
f 1 - Temporary layoff, will be called for work
PLEASE
snout (date)
t" I THIS Employment Security DePWIMenl
-We now have wok for We k dlvlduN.
P. 0. Boa 992
Faro) P
To: Pat Angeles, Washington 96362 - The IrAvdual returned to work on 1
(data) v }'
_ Clahlent war not M our errpby, -
PubLLc Works DLrector 1/30,(,84 (206)385-3505
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Es, MEMO=
TO; PAYROLL DEPARTMENT
=?usE EN,E 1-1-11C 1N,NaE sJ N -N I,-IDS TO ueE : .
EFFECT S e[ E 28 o ,E 984
EN.EO.EE ALLan J. E3aunal<
SOCIAL SECON T. No _538-42-9560 pEpT. road
THE CHANGE(S)
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REASON FOR THE CHANGE(S)
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