Utah Department of Workforce Services

UTAH DEPT OF WORKFORCE SERVICES Unemployment Insurance

UI DIVISION
140 EAST 300 SOUTH
PO BOX 45277
Opt-In Agreement
SALT LAKE CITY, UT 84145-0266

ELECTRONIC: 5/3/2021 SSN: xxx-xx-6683

JONATHAN DANIEL
1997 N 1225 W
CLINTON, UT 84015

1. I agree to receive all my correspondence from the Department of Workforce Services (DWS),
Unemployment Insurance Division at http://jobs.utah.gov “My UI Account”, referred to as Electronic
Correspondence or EC.

2. I agree that EC will be my correspondence address of record for DWS Unemployment Insurance.

3. I agree to read all correspondence that DWS sends to EC.

4. I agree to respond as required by DWS to all correspondence that DWS sends to EC.

5. I understand that failure to respond as required by DWS may result in a denial of my unemployment
insurance benefits.

6. I understand that DWS reserves the right to contact me by any other methods in addition to or instead
of EC.

7. I understand that if I want to discontinue receiving all my correspondence from DWS electronically, I
must log into EC and complete the “OPT-OUT” procedure as instructed.

8. I understand that DWS reserves the right to discontinue sending correspondence to EC for various
reasons, including if my claim becomes inactive, or the claim year ends.

9. I understand that if DWS discontinues sending correspondence to EC, no new correspondence will be
sent to EC until I sign a new agreement with DWS.

10. I understand that if DWS discontinues sending correspondence to EC, other correspondence methods,
such as postal mail will be used, to contact me.
Opt In Agreement Completed: 5/3/2021

Doc ID: 32634952 PID: DO NOT WRITE BELOW THIS LINE DWS-UI Form 610CI - Rev 4/15

**32634952**