Notice of Potential Availability of Unemployment Benefits
This document notifies employees about potential unemployment insurance benefits. It provides essential information regarding eligibility and filing a claim. This notice is crucial for both employers and employees during employment separation.
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How do I fill this out?
To fill out this form, start by gathering your personal information as well as your employer's details. Ensure you have your earnings information ready, including year-to-date earnings and last week's earnings. Follow the instructions on each section carefully to ensure accurate completion.

How to fill out the Notice of Potential Availability of Unemployment Benefits?
1
Gather necessary personal and employer information.
2
Input your employment details like start date and last date worked.
3
Complete the earnings section with accurate figures.
4
Choose the reason for separation from the provided options.
5
Review the completed form for accuracy before submission.
Who needs the Notice of Potential Availability of Unemployment Benefits?
1
Employees who have recently separated from their job need this form to apply for unemployment benefits.
2
Employers must provide this form to employees to comply with legal obligations.
3
HR departments use this form to assist employees with their unemployment claims.
4
State agencies require this document for processing unemployment benefit applications.
5
Financial advisors may use this form to guide clients about potential unemployment benefits.
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What are the instructions for submitting this form?
To submit this form, you can fax it to the Unemployment Insurance Division at 303-318-8980. Alternatively, you can mail it to the local unemployment office. For immediate submission, consider the online filing option available at https://cdle.colorado.gov/unemployment, or call the division at 303-318-9000 for assistance.
What are the important dates for this form in 2024 and 2025?
For 2024, ensure to stay updated regarding the submission deadlines for unemployment claims. Important dates may vary, so check with the local unemployment office. In 2025, similar timelines will apply, so be proactive.

What is the purpose of this form?
The purpose of this form is to inform employees about their rights to claim unemployment insurance benefits upon separation. It serves as a legal requirement for employers to provide this documentation to employees. Additionally, it helps streamline the application process for unemployment benefits.

Tell me about this form and its components and fields line-by-line.

- 1. Employee Name: Full name of the employee.
- 2. Employee Address: Current address of the employee.
- 3. Employee Start Date of Employment: Date when the employee started working.
- 4. Employee Year-to-Date Earnings: Total earnings of the employee for the year up to separation.
- 5. Employer Legal Business Name: Legal name of the employer's business.
- 6. Employer Trade Name: Commonly used name of the business.
- 7. Employee SSN: Last four digits of the employee's Social Security Number.
- 8. Employee Last Date Worked: Last date the employee worked at the company.
- 9. Earnings for the Last Week Worked: Earnings of the employee for the last week worked.
- 10. Federal Employer Identification Number: FEIN of the employer.
- 11. Employer Address: Address of the employer.
- 12. Reason for Separation: Reason for separation from the company.
What happens if I fail to submit this form?
Failing to submit this form can result in delays in your unemployment benefits. You may not be able to claim the benefits you are entitled to without proper documentation. It's crucial to ensure timely submission to avoid these issues.
- Delay in Benefits: Without submission, there may be a lag in receiving unemployment benefits.
- Ineligibility for Claims: Failure to complete the form may render you ineligible for unemployment benefits.
- Unclear Separation Reasons: Not submitting this form can lead to misunderstandings about your separation with the employer.
How do I know when to use this form?

- 1. To Claim Unemployment Benefits: Use this form to start the process of claiming your unemployment benefits.
- 2. For Employer Compliance: Employers must provide this form to employees as a legal requirement.
- 3. For Record Keeping: It is also used for personal record-keeping around separation from employment.
Frequently Asked Questions
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Begin by gathering your personal and employment information, then follow the prompts provided on the form.
Can I save the edited PDF?
Yes, after editing, you can download the updated PDF for your records.
Who needs to fill out this form?
Employees who have separated from their job and are looking for unemployment benefits need to fill this out.
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What information do I need to complete this form?
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