Form 2602 "Unemployment Insurance Benefits Request for Hearing" - Oregon

What Is Form 2602?

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 August 1, 2018;
  • The latest edition provided by the Oregon Employment Department;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 2602 by clicking the link below or browse more documents and templates provided by the Oregon Employment Department.

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Download Form 2602 "Unemployment Insurance Benefits Request for Hearing" - Oregon

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Unemployment Insurance
Benefits Request for Hearing
Complete this form to request a hearing on an unemployment insurance benefits administrative decision.
During the appeal process, continue to file weekly claims for each week you wish to request benefits. If a hear-
ings decision allows back payments for weeks previously covered by a denial or disqualification, you must have
made on-time weekly claims to receive payment for those weeks.
You must request a hearing by the appeal deadline shown on your administrative decision. If you are request-
ing a hearing after that date has passed, you must include a written statement about why you are making your
request late.
Appellant:
 Claimant
Name:
Phone Number:
 Employer
Claimant Name:
Customer ID/Last 4 of SSN:
(First)
(Last)
Employer (if applicable):
Business Name:
Employer Representative Name, if known:
Decision(s) Being Appealed
Number(s):
Date(s):
Issue(s) on Appeal:
 Incarceration
 Transportation
 School Attendance
 Discharge
 Quit
 Leave of Absence
 Labor Dispute
 Suspension
 Ability to Work
 Use of School Wages
 Relief of Charges
 Registering for Work
 Actively Seeking Work
 Job Refusal
 Child Care
 Availability for Work
 Other (Explain Below)
 Failure to Apply for Work
Why you disagree with the decision(s):
Do you have a representative?
If yes, name:
(First)
(Last)
 Yes
 No
Do you need an interpreter to fully participate in the hearing?
 Yes
 No
If yes, what language:
Do you need any other accommodations to fully participate in the hearing?
 Yes
 No
If yes, what accomodation(s) is needed:
Hearings are scheduled Monday through Friday from 8:00 AM to 4:30 PM. Are there any specific days or
times in the next 90 days you will not be available for a hearing?
 Yes
 No
If yes, please specify the days or times:
You may submit this form by:
Email: OED_UI_HEARINGSREQ@oregon.gov | Fax: (503)947-1335
Mail:
Employment Department • 875 Union St NE • Salem, OR 97301
Oregon
The Oregon Employment Department is an equal opportunity employer/program. Auxiliary aids and services are available upon request to
individuals with disabilities. Language assistance is available to persons with limited English proficiency at no cost.
El Departamento de Empleo de Oregon es un programa que respeta la igualdad de oportunidades.Disponemos de servicios o ayudas auxiliares,
formatos alternos y asistencia de idiomas para personas con discapacidades o conocimiento limitado del inglés, a pedido y sin costo.
Employment.Oregon.gov | FORM2602 (0818)
Unemployment Insurance
Benefits Request for Hearing
Complete this form to request a hearing on an unemployment insurance benefits administrative decision.
During the appeal process, continue to file weekly claims for each week you wish to request benefits. If a hear-
ings decision allows back payments for weeks previously covered by a denial or disqualification, you must have
made on-time weekly claims to receive payment for those weeks.
You must request a hearing by the appeal deadline shown on your administrative decision. If you are request-
ing a hearing after that date has passed, you must include a written statement about why you are making your
request late.
Appellant:
 Claimant
Name:
Phone Number:
 Employer
Claimant Name:
Customer ID/Last 4 of SSN:
(First)
(Last)
Employer (if applicable):
Business Name:
Employer Representative Name, if known:
Decision(s) Being Appealed
Number(s):
Date(s):
Issue(s) on Appeal:
 Incarceration
 Transportation
 School Attendance
 Discharge
 Quit
 Leave of Absence
 Labor Dispute
 Suspension
 Ability to Work
 Use of School Wages
 Relief of Charges
 Registering for Work
 Actively Seeking Work
 Job Refusal
 Child Care
 Availability for Work
 Other (Explain Below)
 Failure to Apply for Work
Why you disagree with the decision(s):
Do you have a representative?
If yes, name:
(First)
(Last)
 Yes
 No
Do you need an interpreter to fully participate in the hearing?
 Yes
 No
If yes, what language:
Do you need any other accommodations to fully participate in the hearing?
 Yes
 No
If yes, what accomodation(s) is needed:
Hearings are scheduled Monday through Friday from 8:00 AM to 4:30 PM. Are there any specific days or
times in the next 90 days you will not be available for a hearing?
 Yes
 No
If yes, please specify the days or times:
You may submit this form by:
Email: OED_UI_HEARINGSREQ@oregon.gov | Fax: (503)947-1335
Mail:
Employment Department • 875 Union St NE • Salem, OR 97301
Oregon
The Oregon Employment Department is an equal opportunity employer/program. Auxiliary aids and services are available upon request to
individuals with disabilities. Language assistance is available to persons with limited English proficiency at no cost.
El Departamento de Empleo de Oregon es un programa que respeta la igualdad de oportunidades.Disponemos de servicios o ayudas auxiliares,
formatos alternos y asistencia de idiomas para personas con discapacidades o conocimiento limitado del inglés, a pedido y sin costo.
Employment.Oregon.gov | FORM2602 (0818)