Form K-BEN314 "Labor Dispute Statement - Claimant" - Kansas

What Is Form K-BEN314?

This is a legal form that was released by the Kansas Department of Labor - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2017;
  • The latest edition provided by the Kansas Department of Labor;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form K-BEN314 by clicking the link below or browse more documents and templates provided by the Kansas Department of Labor.

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Download Form K-BEN314 "Labor Dispute Statement - Claimant" - Kansas

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KANSAS DEPARTMENT OF LABOR
MAIL:
Unemployment Contact Center
www.dol.ks.gov
P.O. Box 3539
LABOR DISPUTE STATEMENT – CLAIMANT
Topeka, KS 66601-3539
FAX:
(785) 296-3249
K-BEN 314 Web (Rev. 10-17)
Submit
EMAIL*:
*See important Email Notice on website.
Complete and return this form within seven days of the date you filed your claim. Failure to reply by this date may result in
a denial of benefits or possible overpayment.
Claimant name:
Social Security number:
___________________________________________________
_______________________
(
)
Employer:
Phone:
__________________________________________________________________
____________________________
Employer street, city, state, ZIP:
__________________________________________________________________________________
Your position title:
_______________________________________________________________________________________________
Is your job covered by the labor-management agreement which is now in dispute?
YES
NO
Are you a member of a union?
YES
NO
(
)
If YES, name and local number:
Phone:
_______________________________________________
____________________________
Union street, city, state, ZIP:
______________________________________________________________________________________
Was the last location you worked being picketed?
YES
NO
If YES, by what union (name and local number)?
____________________________________________________________________
Did you refuse to cross the picket line when reporting for work?
YES
NO
Did you leave your job when the picket line was established?
YES
NO
Explain the situation in detail that caused you to stop work:
Name and title of individual who told you to stop work or not to return to work the next day:
_______________________________________________________________________________________________________________
CERTIFICATION: I certify that the information I have provided is correct and complete, and I understand the willful or intentional
misrepresentation or failure to disclose a material fact is punishable under the Kansas Employment Security Law.
(
)
Signature: _________________________________________________ Phone: __________________________ Date: _______________
KANSAS UNEMPLOYMENT CONTACT CENTER
Kansas City Area (913) 596-3500 • Topeka Area (785) 575-1460 • Wichita Area (316) 383-9947 • All Other Areas (800) 292-6333
KANSAS DEPARTMENT OF LABOR
MAIL:
Unemployment Contact Center
www.dol.ks.gov
P.O. Box 3539
LABOR DISPUTE STATEMENT – CLAIMANT
Topeka, KS 66601-3539
FAX:
(785) 296-3249
K-BEN 314 Web (Rev. 10-17)
Submit
EMAIL*:
*See important Email Notice on website.
Complete and return this form within seven days of the date you filed your claim. Failure to reply by this date may result in
a denial of benefits or possible overpayment.
Claimant name:
Social Security number:
___________________________________________________
_______________________
(
)
Employer:
Phone:
__________________________________________________________________
____________________________
Employer street, city, state, ZIP:
__________________________________________________________________________________
Your position title:
_______________________________________________________________________________________________
Is your job covered by the labor-management agreement which is now in dispute?
YES
NO
Are you a member of a union?
YES
NO
(
)
If YES, name and local number:
Phone:
_______________________________________________
____________________________
Union street, city, state, ZIP:
______________________________________________________________________________________
Was the last location you worked being picketed?
YES
NO
If YES, by what union (name and local number)?
____________________________________________________________________
Did you refuse to cross the picket line when reporting for work?
YES
NO
Did you leave your job when the picket line was established?
YES
NO
Explain the situation in detail that caused you to stop work:
Name and title of individual who told you to stop work or not to return to work the next day:
_______________________________________________________________________________________________________________
CERTIFICATION: I certify that the information I have provided is correct and complete, and I understand the willful or intentional
misrepresentation or failure to disclose a material fact is punishable under the Kansas Employment Security Law.
(
)
Signature: _________________________________________________ Phone: __________________________ Date: _______________
KANSAS UNEMPLOYMENT CONTACT CENTER
Kansas City Area (913) 596-3500 • Topeka Area (785) 575-1460 • Wichita Area (316) 383-9947 • All Other Areas (800) 292-6333