Unemployment Insurance

North Carolina Department of Commerce
Division of Employment Security

Unemployment Insurance 3074895
WAGE TRANSCRIPT AND MONETARY DETERMINATION
Mail Date: April 8, 2019

ANTOINE C BENDER
Claimant ID: 11191393
2320 FARMER ST APT D
Program: UI
CHARLOTTE, NC 28208-5161
This is a statement of your wage credits and a monetary determination of your unemployment insurance benefit
rights under Chapter 96 of North Carolina Law.
***This document is an explanation of potential benefits. It is not a guarantee that you will receive unemployment
benefits.***
Base Period Is From: 10/01/2017 Through: 09/30/2018
Employer Employer Name QTR1 QTR2 QTR3 QTR4

Account No. 4/2017 1/2018 2/2018 3/2018
0534824 WRH REALTY SERVICES INC $7,838.04 $6,734.17 $7,917.12 $7,436.81
Seasonal Wages Non-Seasonal Wages Total Wages QTR1 Total QTR2 Total QTR3 Total QTR4 Total
$0.00 $29,926.14 $29,926.14 $7,838.04 $6,734.17 $7,917.12 $7,436.81
Benefit Year Weekly Benefit No. of Maximum Earnings

Begins: Ends: Amount Weeks Benefit Amount Allowance
03/24/2019 03/21/2020 $295.00 12 $3,540.00 $59.00
If you feel this determination is incorrect, you may protest within ten days from the mailing of this determination.
You may file your protest online at des.nc.gov, or mail/fax to the address below. Please return this form, or a copy
with explanation and proof of wages.
Mail/Fax Protest to:
Post Office Box 27967

Raleigh, NC 27611-7967
Fax Number: 919.857.1296
Help us prevent UI Fraud. Report suspected UI Fraud online at des.nc.gov

Post Office Box 25903 Raleigh, North Carolina 27611-5903
NC CLM 550_49.0.0
Accessibility and Nondiscrimination Notice
• IMPORTANT! This document(s) contains important information about your unemployment compensation. Call 1.888.737.0259 or visit our
website at des.nc.gov for free translation assistance. This document may contain important information about your Benefits or Appeal
Rights that may require your response for appealing decisions within 10 days for lower authority and 30 days for higher and judicial
authorities.
• ¡IMPORTANTE! Este(os) documento(s) contiene(n) información importante sobre su compensación por desempleo. Llame
al 1.888.737.0259 o visite nuestro sitio web en des.nc.gov para obtener asistencia gratuita con la traducción. Este documento puede
contener información importante sobre sus beneficios o su derecho de apelación, la cual podría requerir su respuesta para las decisiones
de apelación en un plazo de 10 días para las autoridades de menor nivel y de 30 días para las autoridades de mayor nivel y judiciales.
•
1.888.737.0259 des.nc.gov
• QUAN TRỌNG! Các) tài liệu này chứa thông tin quan trọng về tiền bồi thường thất nghiệp của bạn. Hãy gọi tới số 1.888.737.0259 hoặc
truy cập trang web theo địa chỉ des.nc.gov để được trợ giúp dịch thuật miễn phí. Tài liệu này có thể chứa thông tin quan trọng về các Phúc
Lợi hoặc Quyền Khiếu Nại của bạn, có thể yêu cầu bạn phải trả lời nếu muốn khiếu nại quyết định trong vòng 10 ngày đối với cơ quan có
thẩm quyền cấp dưới và 30 ngày đối với cơ quan có thẩm quyền cấp trên và cơ quan tư pháp.
• IMPORTANT ! Ce(s) document(s) contient/contiennent des informations importantes concernant votre allocation de chômage.
Téléphonez au 1.888.737.0259 ou rendez-vous sur notre site Web à des.nc.gov pour obtenir gratuitement de l'aide en traduction. Ce
document peut contenir des informations importantes sur vos allocations ou sur votre droit de faire appel, qui peuvent, en cas de décisions
d'appel, nécessiter votre réponse dans les 10 jours pour les autorités administratives de niveau inférieur et dans les 30 jours pour les
autorités judiciaires et les autorités administratives de niveau supérieur.
The North Carolina Department of Commerce, Division of Employment Security and Division of Workforce Solutions comply with applicable
Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. We do not exclude people
or treat them differently because of race, color, national origin, age, disability, or sex. The Department of Commerce, Division of Employment
Security and Division of Workforce Solutions Interpreter Services are available to help you.
We provide free aids and services to people with disabilities to communicate effectively with us, such as:
• Qualified American Sign Language (ASL) interpreters,

• Written information in other formats (large print, audio, accessible electronic formats, other formats).
• Free language services to people whose primary language is not English including qualified interpreters and information written in other
languages
If you need these services, contact our Interpreter Services at 1.888.737.0259.
If you believe our agency failed to provide the aforementioned services to you or discriminated against you in another way on the basis of race,
color, national origin, age (40 or older), disability, genetic information, religion, sex or political affiliation, you can file a grievance by contacting
our Legal Services Section using the following methods: by email: grievance@nccommerce.com; by phone: 1.888.737.0259; or by mail: Legal
Services Section, P.O. Box 25903, Raleigh, NC 27611-5903.
You can also file a civil rights complaint with the U.S. Department of Labor, Office for Civil Rights through the Office for Civil Rights Complaint
Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone to: U.S. Department of Labor, Frances Perkins Building, 200
Constitution Ave NW, Washington DC 20210, Phone: 1.866.487.2365.
Complaint forms are available at des.nc.gov.

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North Carolina Department of Commerce

Division of Employment Security

WAGE TRANSCRIPT AND MONETARY DETERMINATION

Mail Date: April 8, 2019

Base Period Is From: 10/01/2017 Through: 09/30/2018

Employer Employer Name QTR1 QTR2 QTR3 QTR4

Benefit Year Weekly Benefit No. of Maximum Earnings

Mail/Fax Protest to:

Post Office Box 27967

Help us prevent UI Fraud. Report suspected UI Fraud online at des.nc.gov

• Qualified American Sign Language (ASL) interpreters,

If you need these services, contact our Interpreter Services at 1.888.737.0259.

Complaint forms are available at des.nc.gov.

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