Attachment A
To UIPL 3-91

Facsimile - Letter Formally Requestincr Title XII Advances

The Honorable Elizabeth H. Dole Secretary of Labor
U.S. Department of Labor
Room S-2523
200 Constitution Avenue, N.W.
Washington, D.C., 20210

Dear Secretary Dole:

I hereby apply for repayable advances to the account of the State of _______________ in the Unemployment Trust Fund from the Federal unemployment account in such Fund, for the months of ___________________ in accordance with the provisions of Section 1201 of the Social Security Act.

My estimate of the amount of advances required to pay compensation under this State's Unemployment Compensation Law is as follows:

Amount Not
to Exceed
Month of
$___________ $___________
$___________ $___________
$___________ $___________

To assure payment of all compensation that becomes due under the Unemployment Compensation Law of this State, it is requested that the actions provided under Section 1201 of the Social Security Act be taken as expeditiously as possible.