Example: bankruptcy

Does Request for Monetary Re-Determination (Form 193)

(Claimant’s Signature) (Date) (Signature of DOES Representative) (Date) Government of the District of Columbia Department of Employment Services Validation Unit 4058 Minnesota Ave., NE Washington, DC 20019 REQUEST FOR MONETARY RE-DETERMINATION Form 193 Revised 02/14 INTERVIEWER’S REMARKS ...

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