Form 2544 "Weekly Claim Form - Self Employment Assistance (Sea) Program" - Oregon

What Is Form 2544?

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

Form Details:

  • Released on July 1, 2014;
  • The latest edition provided by the Oregon Employment Department;
  • 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 2544 by clicking the link below or browse more documents and templates provided by the Oregon Employment Department.

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Download Form 2544 "Weekly Claim Form - Self Employment Assistance (Sea) Program" - Oregon

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Weekly Claim Form – Self Employment Assistance (SEA) Program
Name:
CID or SSN:
BYE:
Saturday
CAT: 850
ending date of the week claimed:
1.
Yes
No
During this week did you devote 40 hours to establishing
your own business and becoming self employed?
2.
Yes
No
During this week did you earn any income from your self
employment?
If yes, the total gross amount of these earnings are: $
During this week did you work as an employee for an
3.
Yes
No
employer?
If yes, please complete the following (for the claimed week):
Number of hours:
Total gross earnings:
$
Did you voluntarily leave work or were you discharged or suspended
4.
Yes
No
from work?
Will you receive or have you received holiday or vacation pay
5.
for any period including this week?
Yes
No
If yes, please complete the following (for the claimed week):
Gross Amount: $
Type of payment:
To return document: Save completed form to your computer and attach to a ‘Reply’ email from
the message from the SEA department.
Certification
I hereby claim benefits under Oregon Employment Department Law. I certify that I have not
claimed benefits under any other state or federal system for any part of this period and that all
the statements I have made on this form are true and correct.
Initial:
Date:
WorkSource Oregon Employment Department •
www.WorkinginOregon.org
Form 2544 (07/2014) page 1 of 1
Weekly Claim Form – Self Employment Assistance (SEA) Program
Name:
CID or SSN:
BYE:
Saturday
CAT: 850
ending date of the week claimed:
1.
Yes
No
During this week did you devote 40 hours to establishing
your own business and becoming self employed?
2.
Yes
No
During this week did you earn any income from your self
employment?
If yes, the total gross amount of these earnings are: $
During this week did you work as an employee for an
3.
Yes
No
employer?
If yes, please complete the following (for the claimed week):
Number of hours:
Total gross earnings:
$
Did you voluntarily leave work or were you discharged or suspended
4.
Yes
No
from work?
Will you receive or have you received holiday or vacation pay
5.
for any period including this week?
Yes
No
If yes, please complete the following (for the claimed week):
Gross Amount: $
Type of payment:
To return document: Save completed form to your computer and attach to a ‘Reply’ email from
the message from the SEA department.
Certification
I hereby claim benefits under Oregon Employment Department Law. I certify that I have not
claimed benefits under any other state or federal system for any part of this period and that all
the statements I have made on this form are true and correct.
Initial:
Date:
WorkSource Oregon Employment Department •
www.WorkinginOregon.org
Form 2544 (07/2014) page 1 of 1