Form DWS-ARK-501 "Application for Unemployment Insurance Benefits" - Arkansas (Marshallese)

Form DWS-ARK-501 is a Arkansas Department of Workforce Services form also known as the "Application For Unemployment Insurance Benefits". The latest edition of the form was released in May 25, 2018 and is available for digital filing.

Download an up-to-date Form DWS-ARK-501 in PDF-format down below or look it up on the Arkansas Department of Workforce Services Forms website.

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Download Form DWS-ARK-501 "Application for Unemployment Insurance Benefits" - Arkansas (Marshallese)

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APPLICATION FOR UNEMPLOYMENT
INSURANCE BENEFITS
Marshallese
LE KO KAKE EO EJ KOMMAN AN CLAIM (*aolep field nan uak rej aikuij kanne)
*TODAY'S DATE:
EFFECTIVE DATE:
*SOCIAL SECURITY NUMBER:
(Local Office Only)
Em j ke am kadedelok im jakemanlok juon am claim kon an jako am jjerbal (unemployment
Aet
Jab *If yes, which State?
claim) ioi bar juon state ilo 12 allon ko remotlok?
(Other than Arkansas)
LETA JINOIN ET EO IOLAP:
*
ETAN BAAMLE EO:
*ETAM:
Mailing Address:
*
ATREEJ - Line 1:
ATREEJ- Line 2:
*CITY:
*STATE:
*ZIP:
Physical Address (If different than above): ATREEJ - Line 1:
ATREEJ- Line 2:
CITY:
STATE:
ZIP:
*
State eo kwoj pad ie:
*
County eo kwoj pad ie:
E-Mail Address:
PHONE EO NMWEO:
MOBILE:
JEJE ENNAAN WOT (MESSAGE):
Ladik
Ledik
*
RAAN IN LOTAK:
*
IIO KO IN JIKUUL:
*
KAIN ROT (SEX):
ARMIJ ROT (ETHNICITY):
Ejap Rihispan
Rihispan
Riamerican Indian ak
Mool in Rihawaii
Bar Jet (Biracial or
Rialaska Native
Armij in Pacific
Multiracial)
Ribelle (White)
Rikilmeej (Black)
Riasia
(RACE)
Ew r ke jorren ilo anbwinin (jaje makitkit)?
Aet
Jab
*
Em j ke am kar jerbal ilo bar juon state(s)
Aet
Jab
ilowan 18 alon ko remotlok?
*
Kwoj ke juon citizen in United States?
Aet
Jab
Elaññe aet, kolajraki State ko:
Elaññe ejab kwe juon citizen, ew r ke am maron, ekkar nan
Aet
Jab
kakien, in jerbal iilo United ASttes ilo 18 allon ko remotlok?
Elaññe aet, je number melim eo:
Em jke am erbal nan juon jikin jelalokijen ko ilowan kar 18 allon ko?
Aet
Jab
Elaññe Aet, rarkabwijrak eok jan jerbal, ew r kar lomnak bwe kwon naj bar rol semester in tok?
Aet
Jab
Elaññe Jab, kwoj ke pad ilo am kakkije ke bwaj iien kakije kio, ejemlok jikuul kin melele in renaj kir eok alkinrecall following
Aet
Jab
the holiday or ak iien kakkijke ilo iien spring?
LAST EMPLOYER INFORMATION
(Armij eo ej kojrbal eok elaññe kwoj jerbal wot - oak - elaññe kwoj jab, etanarmij e oak buainess ear kojerbal eok aliktata)
*
ARMIJEO EAR KOJERBALE EOK:
ACCOUNT N MBA
N MBA IN UNIT:
(Local Office Only)
(Local Office Only)
*
ETAN STREET:
*
CITY:
*STATE:
*COUNTY:
*ZIP CODE:
EMPLOYER PHONE:
DATE LAST W RK ENDED:
Kwoj ke bojak nan jikinjerbal ak jino juon jerbal kaal ilowan wot 10 wiik ko?
Aet
Jab
If yes, date you are scheduled to return to work:
3 - Temporary (120 raan ak diklok jan ) Elaññe
*
Jikin jerbal aliktata?
1-Likieo in awa in jerbal (40 hrs)
2-Part time (Edik jan 40 awa)
aet kwalok raan eo kwon naj rol nan jerbal:
Kamoj Eok make:
Wawein Bwijrak
Rol Jan Jerbal:
Rijerbal in Jikuul:
Bar Jet Un:
Ew r Kar Am Menin Idin
Kiki
Spring Kakkije
Suspension
Kakkije Kon Naninmij
Jan Jerbal:
Kabwijrak Jan Jerbal:
Ejmour
Komman Irre
Summer Kakkije
Ajej Jerbal
Strike jan Jerbal
Enana Lan
Bar Jet Un
Jako/Rumij
Holiday
Kakkije
Holidays
Ejjelok Jerbal
Ejjelok kautiej nan Ritoll
kilok Jan Jikin Jerbal
Jerbal Part time Wot
Ejjemok Jerbal
Idaak/Uno Ekkajur Test
Utame An BaamleMedical
Ekilok Bejinej
Un KoJet
Pad Jikin Tarinae
Ediklok Awa in Jerbal Jan (40 awa)
Page of
DWS-ARK-501 v05252018
APPLICATION FOR UNEMPLOYMENT
INSURANCE BENEFITS
Marshallese
LE KO KAKE EO EJ KOMMAN AN CLAIM (*aolep field nan uak rej aikuij kanne)
*TODAY'S DATE:
EFFECTIVE DATE:
*SOCIAL SECURITY NUMBER:
(Local Office Only)
Em j ke am kadedelok im jakemanlok juon am claim kon an jako am jjerbal (unemployment
Aet
Jab *If yes, which State?
claim) ioi bar juon state ilo 12 allon ko remotlok?
(Other than Arkansas)
LETA JINOIN ET EO IOLAP:
*
ETAN BAAMLE EO:
*ETAM:
Mailing Address:
*
ATREEJ - Line 1:
ATREEJ- Line 2:
*CITY:
*STATE:
*ZIP:
Physical Address (If different than above): ATREEJ - Line 1:
ATREEJ- Line 2:
CITY:
STATE:
ZIP:
*
State eo kwoj pad ie:
*
County eo kwoj pad ie:
E-Mail Address:
PHONE EO NMWEO:
MOBILE:
JEJE ENNAAN WOT (MESSAGE):
Ladik
Ledik
*
RAAN IN LOTAK:
*
IIO KO IN JIKUUL:
*
KAIN ROT (SEX):
ARMIJ ROT (ETHNICITY):
Ejap Rihispan
Rihispan
Riamerican Indian ak
Mool in Rihawaii
Bar Jet (Biracial or
Rialaska Native
Armij in Pacific
Multiracial)
Ribelle (White)
Rikilmeej (Black)
Riasia
(RACE)
Ew r ke jorren ilo anbwinin (jaje makitkit)?
Aet
Jab
*
Em j ke am kar jerbal ilo bar juon state(s)
Aet
Jab
ilowan 18 alon ko remotlok?
*
Kwoj ke juon citizen in United States?
Aet
Jab
Elaññe aet, kolajraki State ko:
Elaññe ejab kwe juon citizen, ew r ke am maron, ekkar nan
Aet
Jab
kakien, in jerbal iilo United ASttes ilo 18 allon ko remotlok?
Elaññe aet, je number melim eo:
Em jke am erbal nan juon jikin jelalokijen ko ilowan kar 18 allon ko?
Aet
Jab
Elaññe Aet, rarkabwijrak eok jan jerbal, ew r kar lomnak bwe kwon naj bar rol semester in tok?
Aet
Jab
Elaññe Jab, kwoj ke pad ilo am kakkije ke bwaj iien kakije kio, ejemlok jikuul kin melele in renaj kir eok alkinrecall following
Aet
Jab
the holiday or ak iien kakkijke ilo iien spring?
LAST EMPLOYER INFORMATION
(Armij eo ej kojrbal eok elaññe kwoj jerbal wot - oak - elaññe kwoj jab, etanarmij e oak buainess ear kojerbal eok aliktata)
*
ARMIJEO EAR KOJERBALE EOK:
ACCOUNT N MBA
N MBA IN UNIT:
(Local Office Only)
(Local Office Only)
*
ETAN STREET:
*
CITY:
*STATE:
*COUNTY:
*ZIP CODE:
EMPLOYER PHONE:
DATE LAST W RK ENDED:
Kwoj ke bojak nan jikinjerbal ak jino juon jerbal kaal ilowan wot 10 wiik ko?
Aet
Jab
If yes, date you are scheduled to return to work:
3 - Temporary (120 raan ak diklok jan ) Elaññe
*
Jikin jerbal aliktata?
1-Likieo in awa in jerbal (40 hrs)
2-Part time (Edik jan 40 awa)
aet kwalok raan eo kwon naj rol nan jerbal:
Kamoj Eok make:
Wawein Bwijrak
Rol Jan Jerbal:
Rijerbal in Jikuul:
Bar Jet Un:
Ew r Kar Am Menin Idin
Kiki
Spring Kakkije
Suspension
Kakkije Kon Naninmij
Jan Jerbal:
Kabwijrak Jan Jerbal:
Ejmour
Komman Irre
Summer Kakkije
Ajej Jerbal
Strike jan Jerbal
Enana Lan
Bar Jet Un
Jako/Rumij
Holiday
Kakkije
Holidays
Ejjelok Jerbal
Ejjelok kautiej nan Ritoll
kilok Jan Jikin Jerbal
Jerbal Part time Wot
Ejjemok Jerbal
Idaak/Uno Ekkajur Test
Utame An BaamleMedical
Ekilok Bejinej
Un KoJet
Pad Jikin Tarinae
Ediklok Awa in Jerbal Jan (40 awa)
Page of
DWS-ARK-501 v05252018
APPLICATION FOR UNEMPLOYMENT
INSURANCE BENEFITS
Marshallese
*
Em j an kar bar w r am jabrewot jerbal alkin kar JIKIN JERBAL EO AM AIKTATA
Aet
Jab
*
JikinJerbal Eo Am ear ke jipañ Eok Iumin Jidik IIen?
Aet
Jab
*
Kain jerbal rot eo kwar kommane ilo jerbal eo am aliktata?:
JIKINJERBAL EO JUON (*Kadedeik im Kanne aolep Field in Melele Ko)
*
ARMIJEO EAR KOJERBALE EOK:
ACCOUNT N MBA
N MBA IN UNIT:
(Local Office Only)
(Local Office Only)
*
ETAN STREET:
*CITY:
*STATE:
*COUNTY:
*ZIP CODE:
EMPLOYER PHONE:
ORIGINAL HIRE DATE:
DATE LAST W RK ENDED:
Kwoj ke bojak nan jikinjerbal ak jino juon jerbal kaal ilowan wot 10 wiik ko?
Aet
Jab
If yes, date you are scheduled to return to work:
3 - Temporary (120 raan ak diklok jan ) Elaññe
*
Jikin jerbal aliktata?
1-Likieo in awa in jerbal (40 hrs)
2-Part time (Edik jan 40 awa)
aet kwalok raan eo kwon naj rol nan jerbal:
Wawein Bwijrak
Kamoj Eok make:
Rol Jan Jerbal:
Rijerbal in Jikuul:
Bar Jet Un:
Ew r Kar Am Menin Idin
Kiki
Spring Kakkije
Suspension
Jan Jerbal:
Kakkije Kon Naninmij
Kabwijrak Jan Jerbal:
Ejmour
Komman Irre
Summer Kakkije
Ajej Jerbal
Strike jan Jerbal
Enana Lan
Bar Jet Un
Jako/Rumij
Holiday
Kakkije
Holidays
Ejjelok Jerbal
Ejjelok kautiej nan Ritoll
kilok Jan Jikin Jerbal
Jerbal Part time Wot
Ejjemok Jerbal
Idaak/Uno Ekkajur Test
Utame An BaamleMedical
Ekilok Bejinej
Un KoJet
Pad Jikin Tarinae
Ediklok Awa in Jerbal Jan (40 awa)
ELIGIBILITY INFORMATION (*Kadedeik im Kanne aolep Field in Melele Ko )
Kwoj konaan ke bwe ren b k Federal Taxes
*
Ew r ke nejum ajri/ro jet kwoj lkejparok im lale ir im?
Aet
Jab
jan kolle ko am?
Aet
Jab
*
If Elanne aet, em jke am komman kar k nan air lale ir ilo iien am
kapok am jerbal?
*
Kwoj ke ebb k am jaan jan wwawein kein ilal:
Aet
Jab
Em j ke am makoko in b ke jabrewot jerbal akin an jako am kar jerbal?
Aet
Jab
*
Kolle Ilo IIen Kakkije?
Aet
Jab
Ejanin alikar
Aet
No
*
Kolle ilo Iien Naninmij?
Aet
Jab
Elanne jab, kwoj ke lomnak in naj jikuul?
Aet
Jab
*
Kolle Eo Aliktata?
Aet
Jab
Elanne aet, ew r ke juo raan eo kwoj omnak in jikuu tokalik?
Aet
Jab
*
Ajejej jan profit ko?
Aet
Jab
Undecided
*
Kolle Ilo IIen Am Bwijrak (Off)?
Aet
Jab
Em j ke am jerbal ipp n Kien (Federal Employment) ilo18 allon ko
*
Kwoj ke ebb k ak applae nan jaan in
remotlok? (ejab kobatok jerbal in tarinae
Aet
Jab
retire jan jerbal ko am mokta ak jikin ko jet
Elanne aet
*1) )Ew r ke am copy in SF-8 or SF-50? (ES 931 Form)
Aet
Jab
ekoba social security? (not including social
security)
*2) Ew r ke kein kamool in men eo wonaam eliktata your
Aet
Jab
last earnings? (ES 935 Form)
Aet
Jab
*
Kwoj maron ke jino jerbal kio kio wot?
Aet
Jab
*
Kwoj maron ke jerbal Full Time?
Aet
Jab
*
Em j ke am kar juon eo ear jerbal in ritarinae ilo18 Alloñ ko remotlok?
Aet
Jab
*
Elaññe Aet, ew r ke am copy in DD-214 eo am?
Aet
Jab
*
Ew r ke ial nan jikin jerbal eo am ke em j
komman kar k nan ial nan kwe?
*
Elaññe Aet, aikuij w r Form 970
Aet
Jab
*
Elaññe Jab, aikuij w r MA - 843
*
Ew r ke uame ilo anbwinnum eo enaj
bobrae eok jan am maron k
an jerbal eo
*
Kwoj ke elolo am jerbal kon wot Union?
Aet
Jab
am?
Aet
Jab
*
Elaññe Aet, Etan
*
Kwoj ke jerbal ippam make, jerbal kon
Local N mba eo an:
kontrak ak ilo jikin kaip eo ej b brae eok jan
am kappok jikin am jerbal ak jino am jerbal ?
Aet
Jab
*
Ededelok ke am kolle men eo kunam?
Aet
Jab
Ij kio je eta nan a jerbal im ikit akile kojjela eo kake an jako aojerbal, im kajjit k kake juon ak kake jimwe ko a ikijien j n in jipañ iumin Kakien
iumin Department of W rkforce Services. Ij k
an a kar k nan a b k j n in jipañ ko.
Jaini Etam:
Raan:
LOCAL OFFICE USE ONLY
RETURN DATE:
CONTROL DATE:
INTERVIEWER'S INITIALS:
REQUALIFYING WAGES:
Yes
No
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DWS-ARK-501 v05252018
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