Form CLI004L "Notice of Possible Change of Benefit Program (Request for Information to Continue Payment of Weekly Benefits)" - Illinois

What Is Form CLI004L?

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

Form Details:

  • Released on May 1, 2010;
  • The latest edition provided by the Illinois Department of Employment Security;
  • 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 CLI004L by clicking the link below or browse more documents and templates provided by the Illinois Department of Employment Security.

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Download Form CLI004L "Notice of Possible Change of Benefit Program (Request for Information to Continue Payment of Weekly Benefits)" - Illinois

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State of Illinois Department of Employment Security
Phone:
TTY:
Fax:
www.ides.state.il.us
Date Mailed:
Claimant ID:
Notice of Possible Change of Benefit Program
(Request for Information to Continue Payment of Weekly Benefits)
________________________________________________________________
)
(Este es un documento importante. Si usted necesita un intérprete, póngase en contacto con su oficina local.
Our records show that your current payments will end
. However, you may be able to continue to receive weekly
benefits.
You previously filed a claim for Trade Readjustment Allowances (TRA) but reported you performed work in a state outside
of Illinois after your last day of work for
. You may be eligible to be paid unemployment
in the other state. Before benefits under the Trade Act can continue to be paid to you, you must file an unemployment
insurance claim in the state of
. To get information on how to file an unemployment claim
in the state of
, please call your local office at the phone number listed above. You
should inform your local office in Illinois if you are told by the state of
that you are not
eligible for unemployment insurance benefits in the state of
.
You are exhausting your Illinois unemployment insurance benefits and our records show you previously filed a claim for
Trade Readjustment Allowances (TRA). Our records show your last day of work for
was
. If you worked for
after this date, you must report the last date you
worked to your local office at the phone number listed above. If you do not provide a different last day of work for
, the period during which your basic Trade Act benefits are payable to you will be to
. Your claim for Trade Act benefits will be effective
.
Currently, your weekly benefit payments are based on your Trade Readjustment Assistance (TRA) claim. Federal Law
requires that you file a new claim for Illinois state unemployment insurance effective
rather than Federal TRA
benefits. We will process your claim automatically and there is no need for you to report. Our records show that you last
worked for
on
. Please contact your local office at the phone number listed
above if this information is not correct. PLEASE NOTE: An eligible Illinois Unemployment Insurance claim may change
your weekly benefit amount. When your claim is processed, you will be sent a written Finding regarding your eligibility for
Illinois Unemployment Insurance benefits.
Currently, your weekly benefit payments are based on your Trade Readjustment Allowances (TRA) claim. Federal Law
requires that you file a new claim for Illinois state unemployment insurance effective
and we will
automatically process your claim. There is no need for you to report. Our records show that you last worked for
on
. When your claim is processed, you will be sent a written Finding.
You will continue to be paid TRA benefits unless you contact your local office at the phone number listed above and let us
know the information on the Finding is not correct.
CLI004L
Page 1 of 1
Rev. (05/2010)
Print
State of Illinois Department of Employment Security
Phone:
TTY:
Fax:
www.ides.state.il.us
Date Mailed:
Claimant ID:
Notice of Possible Change of Benefit Program
(Request for Information to Continue Payment of Weekly Benefits)
________________________________________________________________
)
(Este es un documento importante. Si usted necesita un intérprete, póngase en contacto con su oficina local.
Our records show that your current payments will end
. However, you may be able to continue to receive weekly
benefits.
You previously filed a claim for Trade Readjustment Allowances (TRA) but reported you performed work in a state outside
of Illinois after your last day of work for
. You may be eligible to be paid unemployment
in the other state. Before benefits under the Trade Act can continue to be paid to you, you must file an unemployment
insurance claim in the state of
. To get information on how to file an unemployment claim
in the state of
, please call your local office at the phone number listed above. You
should inform your local office in Illinois if you are told by the state of
that you are not
eligible for unemployment insurance benefits in the state of
.
You are exhausting your Illinois unemployment insurance benefits and our records show you previously filed a claim for
Trade Readjustment Allowances (TRA). Our records show your last day of work for
was
. If you worked for
after this date, you must report the last date you
worked to your local office at the phone number listed above. If you do not provide a different last day of work for
, the period during which your basic Trade Act benefits are payable to you will be to
. Your claim for Trade Act benefits will be effective
.
Currently, your weekly benefit payments are based on your Trade Readjustment Assistance (TRA) claim. Federal Law
requires that you file a new claim for Illinois state unemployment insurance effective
rather than Federal TRA
benefits. We will process your claim automatically and there is no need for you to report. Our records show that you last
worked for
on
. Please contact your local office at the phone number listed
above if this information is not correct. PLEASE NOTE: An eligible Illinois Unemployment Insurance claim may change
your weekly benefit amount. When your claim is processed, you will be sent a written Finding regarding your eligibility for
Illinois Unemployment Insurance benefits.
Currently, your weekly benefit payments are based on your Trade Readjustment Allowances (TRA) claim. Federal Law
requires that you file a new claim for Illinois state unemployment insurance effective
and we will
automatically process your claim. There is no need for you to report. Our records show that you last worked for
on
. When your claim is processed, you will be sent a written Finding.
You will continue to be paid TRA benefits unless you contact your local office at the phone number listed above and let us
know the information on the Finding is not correct.
CLI004L
Page 1 of 1
Rev. (05/2010)
Print