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Request for Alternate Base Period 2020
Calendar days from the Date Mailed of your last Monetary Benefit Determination* Please print clearly. Include any documentation that could be considered proof of employment and wages such as pay stubs W-2s 1099s vouchers checks tips bonuses meals lodging commissions vacation pay and records of employment and/or payment. Photocopy all supporting documentation onto 8 x 11 single-sided paper. Do not send originals. Write your name the last four digits of you Social Security number and your phone...
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