Form DOL-800 Separation Notice - Georgia (United States)

Georgia DOL-800 Instructions

Provide the following information in the Georgia DOL-800 Form:

1. Write down the employee's name and social security number. If the employee has worked under any other names, list them as well;
2. Indicate the period of the employee's most recent employment;
3. Record the reason for separation. The form lets you choose "lack of work" as the reason - the employee was not scheduled for the normal customary hours, the position was eliminated, or the individual was laid off. If you need to state another reason, describe fully and clearly the circumstances of the separation. Be concise and honest - the inaccurate information may lead to a monetary penalty. It is possible to add a separate sheet of paper if the space on the form is not enough;
4. Provide the employee payment information - the type of payment, its amount and period of time. State the date on which the last payment is to be issued to the employee. Do not include the earned wages or vacation pay;
5. If the employee earned at least $7,300 in your employ, answer "Yes". Enter the average weekly wage;
6. Write down the employer's name, address, and telephone number. The contact information must be current for the communications in regard to any potential claim. Record the Georgia DOL Account Number assigned to the employer - your state DOL Unemployment Insurance Account Number can be found on the Form DOL-4N, Employer's Quarterly Tax and Wage Report;
7. Sign the DOL-800 Form. The form requires the title and signature of the official or the employer's authorized agent who certifies the information in the form is true and correct. Add the date of completion.

Once you fill out the Georgia Separation Notice, give it to the employee. If this individual is no longer available to you, mail the document to the employee's last known address and enter the date you mail it. Only use this document when the employer-employee relationship is terminated. The notice is not required for deceased employees and employees who transfer from one regular or temporary position to another. If you need to file a partial separation notice, use Form DOL-408, Partial Claim Form.

Form DOL-402, Mass Separation Notice, must be completed when twenty-five or more employees are separated on the same day and for the same reason.