|Complete all required entries according to instructions
in the Field Comments/Explanation at the top of the page each time an item
is clicked. After the last entry, click "SUBMIT". If errors are detected,
a message will return with further instructions. Correct the error then
click "SUBMIT" again. When the form has been completed successfully, a
"SUBMISSION ACCEPTED" page will return. Print this "SUBMISSION ACCEPTED"
page for your records.
A Separation Notice Alleging Disqualification should be completed for each
worker who leaves your employ without good cause connected with his work,
is discharged for misconduct connected with the employment, or is unemployed
because of a labor dispute.