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Claimant's Appeal To The Superior Court
CLAIMANT'S APPEAL TO THE SUPERIOR COURT State of Connecticut
Department of Labor
Employment Security Appeals Division

Use the Tab key to move forward a field and Shift-Tab to move back a field.

Please do not use special characters such as "é" and "â" (for example in words such as "café" or "fiancé", and in some proper names as well) when entering your appeal; we have found that these characters can cause the appeal to be dropped by the system. We are working on fixing this problem.

Please also do not paste text into the text boxes as we've found that problems can be caused by doing this as well.


PARTY FILING APPEAL TO COURT: 

 

Board of Review Case Number: 
Date of Board of Review Decision: 

Claimant Information
Claimant Social Security Number:
Claimant Name:
Street:
City:
State: Zip Code: 
Telephone Number: (

Claimant Agent Information (If Applicable)
Claimant Agent Name:
Street:
City:
State: Zip Code: 

Employer Information (If Applicable)
Employer Registration Number:
Employer Name:
Street:
City:
State: Zip Code: 

I disagree with the Board of Review's decision for the following reason(s):


 

If this appeal is not transmitted within 30 days of the decision date, please explain why: 


IMPORTANT:
CLAIMANT - CONTINUE TO FILE: Please check the box below to acknowledge that you understand that you must continue to file claims pending a decision by the Superior Court on your appeal. If you fail to file a claim each week, as directed, no benefits can be paid for those weeks, irrespective of the decision of the Superior Court.


IMPORTANT:
PLEASE BE SURE TO PRINT A COPY OF THE DATA CONFIRMATION PAGE THAT WILL DISPLAY AFTER YOU SUBMIT THIS FORM. KEEP THIS COPY FOR YOUR RECORDS. YOUR COPY OF THE DATA CONFIRMATION PAGE VERIFIES THAT YOUR APPEAL HAS BEEN FILED AND RECEIVED FOR PROCESSING BY YOUR LOCAL AMERICAN JOB CENTER.


IN SUBMITTING THIS FORM, I HEREBY APPEAL THE BOARD OF REVIEW's DECISION TO THE SUPERIOR COURT.




Please refer to A Claimant's Guide to the Appeals Process for more information about the unemployment compensation appeals process. 

 

 


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