Iowa Workforce Development - Unemployment Insurance This form is for Employers to report Unemployed Claimants in Iowa who have refused legitimate job offers. All fields below are required for a successful submission. Name of Business: Employer Account Number * Business E-mail: Worksite Street Address: Worksite City, State, Postal Code: Business Area Code+Telephone: Your Name and Title: Name Of Person Who Made The Job Offer: First and Last Name Of Claimant : Social Security Number of Claimant * Date of Job Refusal: Starting Wage or Salary Offered: How Was The Job Offer Made? Please SelectIn PersonIn WritingBy PhoneBy Email or Other Electronic MeansOther Reason Given For Job Refusal: Description Of Job Refused: Leave this field blank Send Job Offer Decline Form
