Submit Layoff/Closing Notification

Submit Layoff/Closing Notification (WARN)

WARN offers protection to workers, their families, and communities by requiring employers to provide notice 60 days in advance of covered plant closings and covered mass layoffs. This notice must be provided to either affected workers or their representatives (e.g., a labor union); to the State Rapid Response entity (GDOL in Georgia); and to the appropriate unit of local government.

*Required

FEIN * :
Company Name*:
DBA:
Affected Employee Site Information
Industry Classification:
Address Line1*:
Address Line2:
City*:
State*:
Zip Code*:
County*:
Contact Person*:
Contact Job Title*:
Contact Phone Number*:
Contact Email*:
Alternate Contact Person:
Alternate Contact Job Title:
Alternate Contact Phone Number:
Alternate Contact Email:
Number of Employees Affected*:
Layoff Duration*:
Planned Employer Action*:
Expected Date of First Separation*:
Employees Represented by a Union Affected*:
Union Name*:
Union Representative*:
Address Line1*:
Address Line2:
City*:
State*:
Zip*:
*Public Notice Acknowledgement
-All WARN notices are public information and shall be displayed on www.dol.georgia.gov no less than sixty (60) calendar days before the layoff date.
You must check one of the boxes to complete and submit this form*
Request for increased notice - An employer may choose to have the notice made public on an earlier date, beyond the required 60-day mandate. Providing earlier notice may allow for better deployment of resources to better assist transition for the employer as well as its employees.
Please provide the earlier date upon which the employer would like to provide public notice of this event*:
Employer does not request increased notice beyond the 60-day mandate.
* I am authorized to submit this application for a notice on behalf of and my contact information is provided above.
* I am authorized to submit this application for a notice on behalf of and my contact information is not provided above.
Submitter's Company Name*:
Submitter's Name*:
Submitter's Job Title*:
Submitter's Phone*:
Submitter's Email*:

Submit Layoff/Closing Notification (WARN)

Affected Employee Site Information