LA Works Main Logo UNEMPLOYMENT INSURANCE Appeals Form  

(*) Entry Required

Note:
If you are a claimant and want to file an appeal regarding a determination on your unemployment benefits,
you must now file your appeal via HiRE.
Log in here and select File an Appeal from the menu of services under Unemployment Services.

  1. * Confirm you are an Employer.

    Employer

  2. * Name and contact information for person filing the appeal.


    Character Count: (Max 200, remaining 200.)

  3. * What is the claimant's Social Security Number?


  4. What is the name of the employer?

  5. What are the Determination Number(s)?


    Character Count: (Max 200, remaining 200.)

  6. What is the Determination Mailing Date?

  7. What is your Statement of Appeal?


    Character Count: (Max 200, remaining 200.)

  8. What is your e-mail address?

  9. What is your phone number?