"Application for Self-employment Assistance Program (Seap)" - Washington

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Application for Self-employment Assistance Program (Seap) is a legal document that was released by the Washington State Employment Security Department - a government authority operating within Washington.

Form Details:

Released on December 1, 2014;
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Application for Self-Employment

Assistance Program (SEAP)

Name

SSN or claimant ID number

Phone number

(

)

Claimant’s name and address:

Return this form by fax at 800-301-1796 or mail it to:

Employment Security Department

PO Box 19019

Olympia, WA 98507-0019

We need this information to make a decision about your unemployment claim. After we receive your response,

we will contact you by phone if we need additional information.

You have the right to an interview by telephone or in person before a decision is made. If you want an

interview, contact the claims center. You may have any person, including an attorney, assist you at the

interview. You may present evidence, documents, or witnesses; cross-examine witnesses or parties present; and

ask for a copy of all records or documents on the issue.

Please complete and return this questionnaire to the address above.

You may be eligible to participate in the Self-Employment Assistance Program (SEAP) while receiving

unemployment benefits. For a list of approved providers, go to

www.esd.wa.gov/jobs-and-training/SEAP-

approved-providers

or contact your nearest WorkSource employment center.

If approved for SEAP, you do not have to look for work while participating in the training program. We will

decide if you can be approved based on your answers to these questions.

Note: We do not pay for books, tuition or program-related fees. Approval does not extend the number of weeks

you can collect unemployment benefits. Your unemployment benefits may run out before the end of your

program. If you have questions about SEAP or this application you may call the Training Benefit Unit at 877-

600-7701 or email your questions to

seacat@esd.wa.gov

Section 1 -- Self-Employment Assistance Program information

1. Program provider information:

Name: ____________________________________________________________________________

Address: __________________________________________________________________________

Phone number: _____________________________________________________________________

Program contact person: _____________________________________________________________

2. Program name: ________________________________________________________________________

3. Program start date: _____________________________________________________________________

4. Program end date: ______________________________________________________________________

(This includes all elements of the program: structured curriculum, business counseling, technical assistance, and

requirements to engage in activities relating to setting up a business and becoming self-employed.)

Self-Employment Assistance Program (SEAP) Application

Page 1 of 3

(Rev. 12/2014)