Employee Work Refusal Documentation

Although appropriate action will be taken with those individuals currently receiving unemployment benefits, not all submissions will trigger return correspondence. Employers can also visit WorkInTexas.com and follow these instructions for reporting why an applicant wasn't hired.

Indicates required information

Employer Information

Employer Name

Employer Account Number

Employer Point of Contact Name

Employer Point of Contact Phone

Claimant Information

First Name

Middle Initial

Last Name

Claimant Social Security Number

Date of Job Offer

Job Offer Method

Position Offered

Work Schedule

Were the wages, hours, or conditions of the work offer same as past?

Rate of Pay

Reason for Refusal

Refusal Other Description

If the person did not appear for the interview or refused the job due to a reason not listed, select Other from the Reason for Refusal drop-down menu, and give a short description in the Refusal Other Description field.