UC-1081(Rev11/99) Connecticut Department of Labor

INSTRUCTIONS TO EMPLOYERS USING FORM UC-62V

FOR A TEMPORARY MASS SHUTDOWN

The Vacation Shutdown New Claim for Unemployment Compensation Benefits, Form UC-62V, is to be used
for cases of Temporary Mass Shutdown of six (6) weeks duration or less. Required separation information should be
entered in Section III of Form UC-62V. This section also serves as the Unemployment Notice. Supplies of form UC-
62V are available from the Department of Labor’s Claims Examination Unit in Wethersfield. See reverse for
instructions on how to order these forms.

Form UC-62V should be issued to each employee being affected by your temporary layoff and receiving less than full
time pay for the shutdown period. This form should be given to them on or before the last day of work before the
shutdown. PLEASE NOTE: If the reason for unemployment is other than a lack of work, issue an
Unemployment Notice form UC-61 (“pink slip”) instead of form UC-62V.

Follow these instructions carefully to avoid delays in the processing of your employees’ claims

• Complete Items 1-10 and 12-14 in Section III of the UC-62V. It is important that your correct Connecticut
Employer Registration Number be provided in Section III, Item 1. The employee’s Return to Work Date
must be provided in Item 9 to use form UC-62V. Failure to provide the return to work date will delay processing
of the claim.

• FOR CONSTRUCTION COMPANIES: Pursuant to Public Act 93-243, any UC-62V issued by a construction
company to a construction worker must include the individual’s Classification Code as contained in the
Classifications and Statistical Codes Manual published by the National Council on Compensation Insurance, Inc.
(NCCI). A worker’s Classification Code should be based on the majority of hours charged to the worker’s most
recent pay period preceding the issuance of form UC-62V. You should put the worker’s Classification Code in
Item 2, NCCI Code/Clock Number. You may be contacted by a Claims Examination representative for this
Classification Code if it has been omitted.

• Please complete the information regarding payments made to the employee for days beyond the last day of work.
For example, an individual with a daily wage of $50 last worked Monday, November 22, 1999, received holiday
pay for Thursday, November 25, 1999 and vacation pay for Friday, November 26, 1999. The wages of $50
should be reported in Item 6. Items 10, 12 & 13 in Section III should be completed with the holiday and
vacation pay as illustrated:

6.WAGES FOR LAST WEEK OF WORK FROM SUNDAY

TO DASTE LAST WORKED (if less than full week)

NO. OF HOURS 8 WAGES $50

10. Will any payment be made or has any NO

Payment been made which is not
wages for work actually performed? YES

12. TYPE OF PAYMENT (If yes above) 13. LAST DATE COVERED BY PAYMENT
1. Severance 2. Vacation
3. Holiday 4. Other 1 1 2 8 9 9

TYPE No. of Hours/Days Covered AMOUNT DATES COVERED

3 8 Hours 50.00 11/25/99

2 8 Hours 50.00 11/26/99

If no payment is made beyond the employee’s last day of work, Item 10 should be checked “NO”
SEE REVERSE FOR IMPORTANT ADDITIONAL INFORMATION

• Your employees must always complete Sections I & VII of form UC-62V. Sections V, VI & VIII should
only be completed by the employee when applicable. Unless you have made other filing arrangements,
employees should be instructed to mail their claim forms to Claims Examination, 200 Folly Brook
Boulevard, Wethersfield, Ct. 06109-1114.

You may wish to contact the Claims Examination Unit in Wethersfield to discuss the options available for
alternatives to requiring employees to personally mail in their individual claims to the Department of Labor.
For example: frequently employer’s collect completed UC62-Vs from their employees and mail them all
to the Department of Labor together. This option ensures that the Department of Labor receives forms for
all affected employees at the same time.

Note: Claims will not be taken in person at Connecticut Works Centers.

If you need to order UC62-V forms, or if you have any questions concerning the Mass Shutdown program,
contact the Claims Examination Unit at (860)263-6635 -

Completed UC62-V Forms should be mailed to:

DEPARTMENT OF LABOR - CLAIMS EXAMINATION UNIT

200 FOLLY BROOK BOULEVARD
WETHERSFIELD, CT. 06109