Request For Eligibility Information {DE 4365REA}

DE 4365REA, REQUEST FOR ELIGIBILITY INFORMATION. This form is used by an individual who failed to attend a mandatory Reemployment Services and Eligibility Assessment (RESEA) appointment. The form explains that attending all scheduled appointments is a requirement to maintain eligibility for Unemployment Insurance (UI) benefits. It then asks the individual to provide an explanation for missing the appointment by checking the appropriate box or writing a complete explanation on the reverse of the form if their reason is not listed. The form also includes a reminder to include their Social Security Number on any additional documents and to return both the RESEA questionnaire and eligibility information request form within 10 days. It warns that failure to do so could result in a denial of benefits. Overall, this letter is used to collect information from the individual about why they missed the RESEA appointment and to determine if they are still eligible for UI benefits. www.FormsWorkflow.com