ETA 5159 (Revised) Claims and Payment Activity | ||||||||||||||||
STATE : XX | REGION: X | REPORT FOR PERIOD ENDING : XX/XX/XXXX | ||||||||||||||
SECTION A. Claims Activities | ||||||||||||||||
Item | Line No. | Initial Claims | ||||||||||||||
Sum of Total (Cols 2-4) |
New Intrastate Excluding Transitional |
Additional Intrastate | Interstate Filed From Agent | Interstate Taken as Agent | Transitional | Interstate Received as Liable State | Incomplete Claims | |||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 29 | |||||||||
UI | 101 | |||||||||||||||
UCFE/No UI | 102 | |||||||||||||||
UCX Only | 103 | |||||||||||||||
Item | Line No. | Eligibility Review | Continued Weeks Claimed | |||||||||||||
Intrastate | Interstate Liable | Intrastate | Interstate Filed From Agent | Interstate Received as Liable | Entering Self Employment | Unique Individuals with at least One Week Claimed |
||||||||||
8 | 9 | 10 | 11 | 12 | 13 | 30 | ||||||||||
UI | 201 | |||||||||||||||
UCFE/No UI | 202 | |||||||||||||||
UCX Only | 203 | |||||||||||||||
Section B. Payment Activities | Weeks and Amounts Compensated | |||||||||||||||
Line No. | State UI Program | UCFE/UCX Programs | ||||||||||||||
All Weeks Compensated | Total Unemployment | Interstate | Total | UCFE/NO UI | UCX Programs | Self Employment, All Programs | ||||||||||
14 | 15 | 16 | 17 | 18 | 19 | 20 | ||||||||||
Number | 301 | |||||||||||||||
Amount | 302 | |||||||||||||||
First Payments for All Unemployment | Final Payments for All Unemployment | |||||||||||||||
Line No. | State UI | UCFE/UCX Programs | State | UCFE/UCX Programs | ||||||||||||
Total | Intrastate | Interstate | Total | UCFE/NO UI | UCX Programs | |||||||||||
UCFE/No UI | UCX Only | |||||||||||||||
21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | |||||||||
Number | 303 | |||||||||||||||
SECTION C. Total State UI First and Final Payments by Demographics | ||||||||||||||||
Race or Ethnicity | American Indian or Alaska Native | Asian | Black or African American | Hispanic or Latino |
Middle Eastern/ North African | Native Hawaiian or Pacific Islander | White | Multiracial and/or Multiethnic |
Information Not Available (INA) | |||||||
31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | ||||||||
First Payments | 400 | |||||||||||||||
Final Payments | 401 | |||||||||||||||
Sex and/or Gender |
Male | Female | Another Gender Identity/ Nonbinary (X) |
Information Not Available (INA) | ||||||||||||
40 | 41 | 42 | 43 | |||||||||||||
First Payments | 500 | |||||||||||||||
Final Payments | 501 | |||||||||||||||
Level of Educational Attainment | < HS Diploma | HS Diploma/GED | Trade/ Technical/ Vocational School or Certification |
Some College | Associate Degree | Bachelor's Degree | Master's Degree | Advanced/ Doctoral Degree |
Information Not Available (INA) | |||||||
44 | 45 | 46 | 47 | 48 | 49 | 50 | 51 | 52 | ||||||||
First Payments | 600 | |||||||||||||||
Final Payments | 601 |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |