Office of Unemployment Insurance Go online: pua.unemployment.ohio.

gov
Operations Call: 1-833-604-0774
P.O. Box 182720
Columbus, Ohio 43218-2720

Forwarding Service Requested

Zachary R. Satterfield
1317 rainbow trail rd April 5, 2021
Waverly, OH 45690

Notice of Corrected Determination

Pandemic Unemployment Assistance

Based on new or corrected wage information that you submitted, we have determined that you are eligible
for weekly Pandemic Unemployment Assistance (PUA) benefit of $189.00. You will receive this amount
each week that you remain unemployed, meet one or more of the COVID-19 scenarios established by the
federal CARES Act, and file for unemployment benefits. PUA benefits are now available for up to 79
weeks, per the American Rescue Plan Act of 2021.

The PUA program expires on September 4, 2021. The American Rescue Plan Act also authorizes a $300
supplemental Federal Pandemic Unemployment Compensation (FPUC) payment for each week that you
are eligible for PUA benefits, from March 13, 2021, through September 4, 2021.

How weekly benefit amounts are calculated: If you worked at least 20 weeks in 2019, your weekly
benefit amount will be 50% of the total amount you were paid, divided by the number of weeks you
worked. This amount may increase if you have allowable dependents. The maximum PUA benefit is the
same as the maximum benefit for Ohio's unemployment program.

PUA Benefit Year Effective Date: 5/10/2020

PUA Benefit Year End Date: 5/8/2021
PUA Weekly Benefit Amount: $189.00
Maximum PUA Benefit amount available during
$14,931.00
your benefit year:

Your Benefit Claim Is Determined by Wages Paid in Your PUA Base Period.
Jan 2019 - Mar Apr 2019 - Jun Jul 2019 - Sep Oct 2019 - Dec Total Gross
2019 2019 2019 2019 Wages Paid
Wages $0.00 $0.00 $0.00 $0.00 $0.00
Totals: $0.00 $0.00 $0.00 $0.00 $0.00
$0.00
Pension Deduction:
Earnings Exclusion: $37.80
Average Weekly Wage: $0.00

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60704767
Appeal Rights:

If you disagree with your weekly benefit amount, you may appeal to request a redetermination. If you do
so, you will need to submit documentation to substantiate the wages you earned during the base period of
your claim (calendar year 2019). This may be done at any time during the Pandemic Assistance Period,
through September 4, 2021. To appeal, please review the "Request for Hearing" information below.

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 REQUEST FOR HEARING

Claimant: Zachary R. Satterfield Claimant ID: 30099786 Issue ID: 0 Correspondence ID: 60704767

TO BE TIMELY, YOUR APPEAL MUST BE RECEIVED NO LATER THAN 21 CALENDAR

DAYS AFTER THE DATE ISSUED. If the 21st day falls on a Saturday, Sunday, or Legal Holiday,
your deadline is extended to the next scheduled business day.

How to Appeal: There are two ways you can appeal a decision. Use only one method to file your
appeal.
1. Online at https://puaa.jfs.ohio.gov. This site will allow you to address all the questions below and
upload any supporting documents through an online interface. Please note: You will need to enter
the Claimant ID, Issue ID, and the Correspondence ID at the top of this page. Please write this
information down in order to file your appeal.

2. Call 1-877-574-0015 to provide the information requested in this form.

1. Name and address of Claimant: 2. Name and address of any employers involved in the
claim:

4. Will you be represented at the hearing by a lawyer,

union business agent, or anyone else?

Yes No
3. Name of the party filing the appeal:
If Yes, write the persons name, address, and telephone
number:

5. Do you need an interpreter?

Yes No
6. Please provide a valid contact number for the
hearing.
If Yes, for what type of language?

You will not be charged for the service.

7. Explain the reasons you disagree with the decision. Provide as many details as possible. Please provide a copy
of your evidence. You may provide additional sheets of paper.

The information provided is true, correct, and complete to the best of my knowledge. I understand there are severe
penalties, including fines and jail, for not telling the truth.

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Signature of the Person Appealing Date

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