Understanding Your Statement of Benefit Charges

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D244440-T Statement of Benefit Charges
State of Washington
Employment Security Department ______
______

This is not a bill Unified Business Identifier
600 500 400 000

ABC Company
1234 5th St.
Anywhere, WA 98000-2237

ES Reference DTO

987564-00-0 150

Mailing Date: 01/04/2003

Quarter Ending: 12/31/2002

Clmt SSN Clmnt Name Base Yr Begins Ent Ben Paid Acct Chrg/Credit

123-45-6789 Claimant, Ima 04/01/01 Reg 2857.00 50.31

Total Employer Account Charges: 50.31

Refer any questions to Employment Security Department, Experience Rating Unit, PO Box 9046, Olympia, WA 98507-9046 or fax (360) 902-9202 or call (360) 902-9670.

We now have an adjustment line that indicates any charges or credits against your account for an individual claimant. If there are any adjustments, the word "ADJUSTMENT" will appear directly under the claimant’s name in the CLMNT NAME column.
"ADJUSTMENT" refers to changes made during the last completed calendar quarter (as shown on your statement), that may reflect a credit for a previous account charge or overpayment credit or a charge due to a base year wage correction.
Helpful Hint: If you combine the amounts from the first line with the amount from the adjustment line, you will arrive at the net charge or credit for that claimant.
If you have a question regarding a former employee’s eligibility for unemployment benefits, contact your local Job Service Center or TeleCenter.
Please write to us with questions about charges or credits on this statement. Address your letter to the Experience Rating/Benefit Charging Unit, PO Box 9046, Olympia, WA 98507-9046 or FAX (360) 902-9202 or call (360) 902-9670.
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