Fill in a Valid Hawaii Uc 253 Template Edit Form

Fill in a Valid Hawaii Uc 253 Template

The Hawaii UC 253 form is a document used by individuals applying for unemployment benefits in Hawaii. It serves as a Record of Contacts Made for Work, detailing the efforts a claimant has made to secure employment. Completing this form accurately is essential for the eligibility review process, so ensure you fill it out by clicking the button below.

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The Hawaii UC 253 form, officially known as the Record of Contacts Made for Work, plays a crucial role in the unemployment insurance process for individuals seeking benefits in the state of Hawaii. This form is designed to document the job search efforts of claimants, ensuring that they actively seek employment while receiving benefits. It requires individuals to provide detailed information about their job contacts, including the date of contact, the employer's name and contact information, the method used to reach out, and the outcome of each interaction. Claimants must also indicate whether they applied for the position and provide the name of the person they contacted. This information is essential for the Unemployment Insurance Division to verify compliance with eligibility requirements. Furthermore, the form includes a certification statement that emphasizes the importance of accuracy and honesty in reporting, as false statements can lead to penalties. Completing the UC 253 form accurately is vital for maintaining eligibility for unemployment benefits and facilitating a smoother review process during eligibility interviews.

Sample - Hawaii Uc 253 Form

UC-253 (11/05)State of Hawaii

Department of Labor and Industrial Relations

UNEMPLOYMENT INSURANCE DIVISION

RECORD OF CONTACTS MADE FOR WORK

Record the contacts you made to obtain work that you reported on your continued claims. Please give this information to the interviewer during your Eligibility Review Interview or as requested. Your "Record of Contacts Made for Work" is subject to verification by the Unemployment Insurance Division.

Claimant's name

Social security number

Please provide the information requested or circle the appropriate response.

Date of

Employer's name, address & phone number

Method of

Name of person contacted

Position applied for

Applica-

Result of contact for

contact

 

contact

 

 

tion filed?

work

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

 

Résumé

 

 

 

 

Phone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OVER - CONTINUE YOUR RECORD OF JOB CONTACTS ON THE BACK OF THIS FORM

RECORD OF CONTACTS MADE FOR WORK - CONTINUED

Please provide the information requested or circle the appropriate response.

Date of

Employer's name, address & phone number

Method of

Name of person contacted

Position applied for

Applica-

Result of contact for

contact

 

contact

 

 

tion filed?

work

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Telephone

 

 

Yes

 

 

 

Internet

 

 

 

 

Address

 

 

 

 

 

In person

 

 

No

 

 

Phone

Résumé

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify this information is true and correct to the best of my knowledge. I am aware the law provides penalties for false statements made for the purpose of obtaining benefits.

Claimant’s signature _____________________________________________________________________________

Date _________________________________________

File Attributes

Fact Name Description
Form Purpose The UC-253 form is used to record job contacts made by individuals seeking unemployment benefits in Hawaii.
Governing Law This form is governed by the Hawaii Revised Statutes, specifically HRS § 383-30, which outlines the requirements for unemployment insurance claims.
Verification Requirement Information provided on the UC-253 is subject to verification by the Unemployment Insurance Division to ensure accuracy.
Submission Timing Claimants must present the completed UC-253 during their Eligibility Review Interview or upon request from the Unemployment Insurance Division.
Contact Information The form requires detailed information about each job contact, including the employer's name, contact method, and the result of the application.
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