Form LWC 77 Separation Notice Alleging Disqualification
Thank you for accessing this Louisiana Workforce Commission Interactive Form. The following is a brief overview of how the form functions.
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.
Submit within 72 hours after each employee has been separated from work.
We encourage you to complete and submit the form online, however; you may download and print a blank copy of this form and/or instructions.
Give a copy to the worker along with "Instructions to the Worker" and Form LWC 87
or, if delivery is impossible, mail to his last known address within 72 hours.
Keep a copy for your records.
Once you have submitted this form electronically, there is no need to mail a copy to LWC.