State referrals and disclosure of unemployment fraud information to DOL OIG

CLASSIFICATION
   EMPLOYMENT AND TRAINING ADMINISTRATION                 Unemployment Insurance
               ADVISORY SYSTEM                            CORRESPONDENCE SYMBOL
          U.S. DEPARTMENT OF LABOR                        OUI/DL
             Washington, D.C. 20210                       DATE
                                                          August 3, 2021


ADVISORY:       UNEMPLOYMENT INSURANCE PROGRAM LETTER NO. 04-17,
                Change 1

TO:             STATE WORKFORCE AGENCIES

FROM:           SUZAN G. LEVINE
                Acting Assistant Secretary

SUBJECT:        Requirement for States to Refer Allegations of Unemployment Compensation
                (UC) Fraud, Waste, Abuse, Mismanagement, or Misconduct to the Department
                of Labor’s (Department) Office of Inspector General’s (DOL-OIG) and to
                Disclose Information Related to the Coronavirus Aid, Relief, and Economic
                Security (CARES) Act to DOL-OIG for Purposes of UC Fraud Investigation
                and Audits

1. Purpose. This Unemployment Insurance Program Letter (UIPL): (1) advises states that they
   must refer allegations which they reasonably believe constitute UC fraud, waste, abuse,
   mismanagement, or misconduct to DOL-OIG; (2) rescinds UIPL No. 29-05; (3) provides
   revised guidance that supersedes Section 5 of UIPL No. 04-17; and (4) requires states to
   disclose confidential UC information related to the Coronavirus Aid, Relief, and Economic
   Security (CARES) Act, as amended, to the DOL-OIG for the purpose of UC fraud
   investigations and audits for the entire pandemic relief period.

2. Action Requested. The Department’s Employment and Training Administration (ETA)
   requests that State Administrators provide the information in this UIPL to appropriate
   program and other staff in state workforce agencies involved in the cross-functional integrity
   task force, Benefit Payment Control, Internal Security (IS), and other integrity-related
   operations.

3. Summary and Background.

   a. Summary – This UIPL provides a description of state responsibilities for notifying DOL-
      OIG of allegations which the state reasonably believes constitutes UC fraud, waste,
      abuse, mismanagement, or misconduct. Attachment I provides a memorandum from
      DOL-OIG that: i) describes DOL-OIG’s process for accepting and reporting fraud, waste,
      abuse, or misconduct referred by states; ii) describes DOL-OIG’s process for notifying
      states of the DOL-OIG’s information requirements; and iii) sets forth states’
      responsibilities under the Inspector General (IG) Act.



   RESCISSIONS                                             EXPIRATION DATE
   UIPL No. 29-05                                          Continuing

   This UIPL rescinds and replaces UIPL No. 29-05, Memorandum of Understanding
   Regarding Unemployment Insurance Criminal Investigations between the U.S.
   Department of Labor’s Office of Inspector General and the Employment and Training
   Administration, issued August 2, 2005.

   This UIPL also supersedes Section 5 of UIPL No. 04-17, Disclosure of Confidential
   Unemployment Compensation (UC) Information to the Department of Labor’s Office of
   Inspector General (OIG), issued on December 16, 2016.

   Additionally, Section 5 of this UIPL expands the description of responsibilities in Section
   4 of this UIPL to require disclosure of confidential UC information for both UC fraud
   investigations and audits within the context of the CARES Act, as amended, including
   administering Pandemic Unemployment Assistance (PUA), Federal Pandemic
   Unemployment Compensation (FPUC), Pandemic Emergency Unemployment
   Compensation (PEUC), Mixed Earners Unemployment Compensation (MEUC), and
   receiving full federal funding for the first week of regular UC for states with no waiting
   week in accordance with Section 2105 of the CARES Act, as amended. This required
   disclosure includes all weeks of unemployment covered by the CARES Act programs,
   which for most states will be weeks of unemployment beginning after January 27, 2020
   through weeks of unemployment ending before September 6, 2021. This includes claims
   for these weeks of unemployment even if states are not able to process them until after
   September 6, 2021.

b. Background – As discussed in UIPL No. 04-17, states must disclose confidential UC
   information to DOL-OIG for the purpose of investigating UI fraud, as a condition for
   proper and efficient administration of the UC program under Section 303(a)(1) of the
   Social Security Act (SSA). Furthermore, as ETA Grant Recipients, states are responsible
   for reporting instances of fraud as described in Training and Employment Guidance
   Letter (TEGL) No. 02-12, Employment and Training Administration (ETA) Grant
   Recipient Responsibilities for Reporting Instances of Suspected Fraud, Program Abuse
   and Criminal Conduct.

   DOL-OIG has a statutory mandate under the Inspector General Act (Pub. L. 95-452, as
   amended), other laws, and delegations by the U.S. Attorney General and Secretary of
   Labor to detect and prevent fraud, waste, and abuse in the Department’s programs and
   operations. To carry out this mandate, DOL-OIG has the authority to conduct audits and
   investigations to discover fraud, waste, and abuse or inefficiencies, and to refer any
   findings to the appropriate program manager for action, or to the U.S. Department of
   Justice, U.S. Attorney, or cognizant prosecutor for criminal or civil prosecution.

   ETA and states must continuously assess the UI program’s vulnerabilities and seek new
   ways to ensure its integrity. In 2005, ETA and DOL-OIG executed a Memorandum of
   Understanding (MOU) to highlight DOL-OIG’s role in investigating cases of fraud and
   other crimes in the UI program. The MOU defined the types of fraud required to be
   reported to the DOL-OIG and established monetary thresholds for states to refer cases to
   DOL-OIG. DOL-OIG agreed to assume responsibility for investigating certain fraud

       cases that meet the established criteria and, upon request, to assist states in certain other
       incidences of fraud or abuse.

       DOL-OIG plays an essential role in working collaboratively with states to investigate
       fraud in state UI programs. Over the years, joint investigations between DOL-OIG and
       states have led to successful prosecutions and monetary recoveries. Many of these
       investigations include successfully pursued sophisticated multi-state fraud schemes by
       organized criminal groups involving millions of dollars in fraudulent claims.

       Additionally, the CARES Act (Pub. L. 116-136), enacted on March 27, 2020, provides,
       among other things, for states to enter into an agreement with the Secretary to administer
       the PUA, FPUC, and PEUC programs. States without a waiting week may also enter into
       an agreement with the Secretary to receive full federal funding of the first week of
       compensable regular UC. Section 2115 of the CARES Act included an appropriation to
       DOL-OIG to carry out audits, investigations, and other oversight activities related to the
       UI provisions of the CARES Act. Section 2116 of the CARES Act provides authority for
       ETA to issue operating instructions or other guidance necessary to carry out the UI-
       related provisions of the CARES Act. See UIPL No. 14-20. The Continued Assistance
       for Unemployed Workers Act of 2020 (Continued Assistance Act), set forth at Division
       N, Title II, Subtitle A of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260),
       extended the dates for states to administer these programs and provided for states to also
       enter into an agreement with the Secretary to administer the MEUC program. See UIPL
       No. 09-21. The American Rescue Plan Act of 2021 (ARPA) (Pub. L. 117-2) further
       extended the dates for states to receive federal funding for the first compensable waiting
       week for regular UC and to administer the PUA, FPUC, PEUC, and MEUC programs
       through September 6, 2021. See UIPL No. 14-21.

4. Guidance. States must maintain a steadfast focus on UI program integrity broadly, and the
   prevention and detection of fraud and improper payments across all UI programs. States
   must adhere to federal laws and guidance establishing program eligibility requirements and
   the fundamental processes that ensure accurate benefit payments. UIPL No. 29-05 is now
   rescinded.

   a. State Responsibilities. States are required to comply with the reporting and UC
      information disclosure processes outlined in the attached DOL-OIG memorandum.
      These reporting processes apply to all new and existing allegations which the state
      reasonably believes constitute fraud, waste, abuse, mismanagement, or misconduct.

       This section supersedes Section 5 of UIPL No. 04-17. There is no federal requirement
       that state UI agencies must enter into an agreement with DOL-OIG before any
       disclosures of confidential UC information are made for the purposes of investigating UC
       fraud, including in 20 C.F.R. Part 603. In addition, if a state makes a permissive
       disclosure of confidential UC information under 20 C.F.R. Part 603.5(i) for audits of UC
       programs, there is also no federal requirement for an agreement.

       States also have a responsibility to report without delay any suspected cases of fraud or
       abuse to their own state investigative agencies as required by state laws or regulations.

   b. Payment of Costs for Disclosure of Information. Reimbursement for the costs of states
      providing the information to DOL-OIG is not required, as disclosure of this information
      for the purpose of investigating UC fraud is necessary for the proper and efficient
      administration of the UC program. In addition, if a state makes a permissive disclosure
      of confidential UC information under 20 C.F.R. 603.5(i) for audits, reimbursement for
      the costs of states providing the information to DOL-OIG is not required. See 20 C.F.R.
      603.8.

   c. Redisclosure Parameters. The DOL-OIG memorandum provided in Attachment I
      provides that DOL-OIG will “redisclose data and information only when necessary for
      purposes consistent with the IG Act, Privacy Act, and other applicable federal laws and
      regulations”. For purposes of UC programs, this includes the regulations set forth at 20
      C.F.R. 603.9(c).

5. Guidance Specific to Administration of the CARES Act UC Programs. Within the
   context of administering PUA, FPUC, PEUC, MEUC, and full federal funding of the first
   week of regular UC for states with no waiting week that is reimbursed in accordance with
   Section 2105 of the CARES Act, as amended, states must disclose all information to DOL-
   OIG for the purposes of investigating UC fraud and for audits of UC programs. Within this
   context, states must adhere to the guidance provided in Section 4 of this UIPL.

   States must also disclose all confidential UC information, including for the regular UC
   program, for audits for weeks covered by the CARES Act programs, which for most states
   will be weeks of unemployment beginning after January 27, 2020 through weeks of
   unemployment ending before September 6, 2021. This includes claims for these weeks of
   unemployment that states are not able to process until after September 6, 2021.

   Further, there is no federal requirement that state UI agencies must enter into an agreement
   with DOL-OIG before any disclosures of confidential UC information are made for the
   purposes of investigating UC fraud and for audits of UC programs, including in 20 C.F.R.
   Part 603.

6. Inquiries. Please direct inquiries to the appropriate ETA Regional Office.

7. References.

          American Rescue Plan Act of 2021 (ARPA), including Title IX, Subtitle A, Crisis
           Support for Unemployed Workers (Pub. L. 117-2);
          Consolidated Appropriations Act, 2021, including Division N, Title II, Subtitle A, the
           Continued Assistance for Unemployed Workers Act of 2020 (Continued Assistance
           Act) (Pub. L. 116-260);
          Coronavirus Aid, Relief, and Economic Security (CARES) Act, including Title II,
           Subtitle A, Relief for Workers Affected by Coronavirus Act (Pub. L. 116-136);

         Section 303(a)(1), SSA (42 U.S.C. 503(a)(1));
         Inspector General Act of 1978, Pub. L. 95-452, as amended;
         20 C.F.R. Part 603 – Federal-State Unemployment Compensation (UC) Program;
          Confidentiality and Disclosure of State UC Information;
         UIPL No. 14-21, American Rescue Plan Act of 2021 (ARPA) – Key Unemployment
          Insurance (UI) Provisions, issued March 15, 2021,
          https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=5669;
         UIPL No. 09-21, Continued Assistance for Unemployed Workers Act of 2020
          (Continued Assistance Act) - Summary of Key Unemployment Insurance (UI)
          Provisions, issued December 30, 2020,
          https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=3831;
         UIPL No. 14-20, Coronavirus Aid, Relief, and Economic Security (CARES) Act of
          2020 – Summary of Key Unemployment Insurance (UI) Provisions and Guidance
          Regarding Temporary Emergency State Staffing Flexibility, issued April 2, 2020,
          https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=3390;
         UIPL No. 04-17, Disclosure of Confidential Unemployment Compensation (UC)
          Information to the Department of Labor’s Office of Inspector General (OIG), issued
          December 16, 2016, https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=7523;
         TEGL No. 02-12, Employment and Training Administration (ETA) Grant Recipient
          Responsibilities for Reporting Instances of Suspected Fraud, Program Abuse and
          Criminal Conduct, issued July 12, 2012,
          https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=9222;
         UIPL No. 29-05, Memorandum of Understanding Regarding Unemployment
          Insurance Criminal Investigations Between the U.S. Department of Labor’s Office of
          Inspector General and the Employment and Training Administration, issued August
          2, 2005, https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=2104; and
         UIPL No. 04-01, Payment of Compensation and Timeliness of Determinations during
          a Continued Claim Series, issued October 27, 2000,
          https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=1746.

8. Attachment(s).

         Attachment I: DOL-OIG Memorandum dated July 30, 2021, “Referral of Suspected
          Unemployment Insurance Fraud, Abuse, and Other Misconduct to the U.S.
          Department of Labor, Office of Inspector General, and Notification of Requirement
          for State Unemployment Insurance Information”

U.S. Department of Labor                  Office of Inspector General
                                          200 Constitution Avenue, N.W.
                                          Washington DC 20210



 July 30, 2021


 MEMORANDUM FOR:                SUZAN G. LEVINE
                                Acting Assistant Secretary
                                Employment and Training Administration

 FROM:                          MICHAEL C. MIKULKA
                                Assistant Inspector General
                                U.S. Department of Labor, Office of Inspector General
                                Office of Investigations-Labor Racketeering & Fraud

 SUBJECT:                       Referral of Suspected Unemployment Insurance
                                Fraud, Abuse, and Other Misconduct to the U.S.
                                Department of Labor, Office of Inspector General, and
                                Notification of Requirement for State Unemployment
                                Insurance Information

 The U.S. Department of Labor, Office of Inspector General (DOL-OIG) has a
 statutory mandate under the Inspector General Act (IG Act), 1 other federal laws,
 and delegations by the U.S. Attorney General and Secretary of Labor to detect
 and prevent fraud, waste, and abuse in DOL programs and operations. To carry
 out this mandate, the DOL-OIG is authorized to conduct audits and investigations
 and refer any findings to the appropriate program manager for action, or to the
 Department of Justice, U.S. Attorney, or cognizant prosecutor for criminal or civil
 prosecution. The purpose of this memorandum is to inform SWAs of the DOL-
 OIG’s intake, processing, and investigation of UI matters referred by SWAs. This
 memorandum also informs SWAs of the DOL-OIG’s notification process for UI
 information/data requirements.

 I.     SWA Notification to the DOL-OIG

 State workforce agencies (SWAs) are obligated to report alleged or suspected
 unemployment insurance (UI) fraud, misfeasance, malfeasance, nonfeasance,
 waste and program abuse, mismanagement, misconduct, and other criminal
 activities to the DOL-OIG, to the Employment and Training Administration (ETA),
 or both. SWAs must also cooperate with the DOL-OIG during its engagements,
 in accordance with the IG Act.

 When reporting alleged or suspected fraud, misfeasance, malfeasance,
 nonfeasance, waste and program abuse, mismanagement, or misconduct and
 other criminal activities to the DOL-OIG, SWA Administrators or their designees

 1 Pub. L. 95–452, 92 Stat. 1101, as amended.

should be cognizant of the DOL-OIG’s criteria specified below. Allegations and
suspicions should be promptly reported to the DOL-OIG through the DOL-OIG’s
regional Special Agent-in-Charge (SAC) with responsibility over the geographic
area that encompasses the cognizant SWA.

When reporting to the DOL-OIG any allegations or suspicions that fit the criteria
below, the SWA Administrator or designee will initiate contact by sending an e-
mail to the responsible DOL-OIG SAC.

II.      Criteria for Reporting to DOL-OIG

SWA Administrators or their designees report the following to the DOL-OIG:

      A. Suspected or alleged illegal or fraudulent activity with a loss in excess of
         $10,000 from the following categories will be reported to the DOL-OIG, but
         with the understanding that upon mutual agreement between the regional
         DOL-OIG SAC and SWA Administrator the dollar threshold for reporting
         may be adjusted on a State-by-State or Regional basis for the following
         programs:

         •   Unemployment Compensation for Federal Employees (UCFE);
         •   Unemployment Compensation for Ex-Service Members (UCX);
         •   Federal-State Extended Benefits (EB);
         •   Disaster Unemployment Assistance (DUA); and
         •   Any temporary UC program enacted by Congress.

      B. Suspected or alleged illegal or fraudulent activity in any amount from the
         following categories:

         •   Internal and external thefts and embezzlements of UI administrative
             funds;
         •   Any matter involving alleged misconduct by a U.S. DOL employee;
         •   Fictitious/fraudulent employer schemes, potentially involving multiple
             states and/or international boundaries;
         •   Schemes involving claims or taxes in multiple states and/or
             international boundaries;
         •   Multi-claimant or multi-state schemes involving identity theft; and
         •   Schemes involving counterfeit benefit checks or multi-victim forgery
             cases such as forged UI weekly certifications and forged UI check
             cashing.

      C. For allegations or suspicions related to the UI program that do not meet
         the criteria above, or when there is uncertainty on whether a suspicion or
         allegation should be reported, the SWA Administrator or designee should
         report the activity as outlined in Section I above, to the DOL-OIG to
         determine if further action is necessary.

       D. Nothing in this memorandum should be construed to limit the SWAs’
          ability to also report suspected fraud or other matters related to a U.S.
          DOL program or employee.

III.      DOL-OIG Notifications of Investigations and Reporting

When a suspected fraud matter is referred to the DOL-OIG by an SWA, the DOL-
OIG will inform the SWA Administrator or designee and ETA Regional
Administrator in writing whether the DOL-OIG will initiate an action, including an
investigation, based on the SWA’s report. This notification will generally take
place within 30 days of a referral being received by the DOL-OIG. If an
investigation is initiated, the SAC will provide the SWA Administrator and ETA
Regional Administrator with a DOL-OIG case number for the matter.

In instances where, in the opinion of the DOL-OIG, a DOL-OIG action or
investigation will be furthered by the continuation of payment of benefits, the
DOL-OIG will notify the SWA Administrator and provide justification for the
request. In all instances involving regular State-UI funds, the decision to
continue to pay benefits or not rests with the SWA Administrator.

At its discretion, the DOL-OIG may accept an invitation from a SWA or a law
enforcement agency to initiate an investigation or conduct joint investigations
involving regular state benefits in a single state. When feasible and mutually
agreed upon, the DOL-OIG will coordinate investigative efforts with the
appropriate SWA personnel. DOL-OIG may provide periodic status updates to
the SWA Administrator and ETA Regional Administrator as appropriate, and
when such updates would not interfere with an investigation.

When DOL-OIG initiates an investigation as a result of information received from
sources other than an SWA, the DOL-OIG may, as appropriate, notify the SWA
Administrator or ETA Regional Administrator of the initiation of the investigation
and provide periodic updates regarding the investigation, so long as such
notifications do not interfere with an investigation.

SWA and ETA personnel are not authorized to redisclose information received
from DOL-OIG regarding ongoing investigations, unless the DOL-OIG SAC gives
prior written approval.

Following completion of an investigation of a suspected fraud matter referred by
an SWA, the SAC will notify the SWA Administrator and ETA Regional
Administrator of the investigation’s outcome. In cases involving state employee
fraud, program weakness, or other issues significant to state-UI program
management, DOL-OIG may provide a memorandum or report to the SWA
Administrator and ETA Administrator detailing the results. DOL-OIG may issue a
memorandum or report to the responsible U.S. DOL management official in

cases involving U.S. DOL employee misconduct. Further, if a DOL-OIG
investigation, audit, or other oversight activity discloses any systemic weakness,
DOL-OIG may provide recommendations for solutions to identified weaknesses.

When appropriate in its communications to stakeholders, DOL-OIG will
acknowledge the contributions of the states and ETA in UI investigations.

IV.      Notification of DOL-OIG Requirement for SWA Electronic Information

The DOL-OIG needs SWA information, including electronic data, for the
performance of its responsibilities pursuant to the IG Act. The DOL-OIG only
accesses such data and information when necessary for a purpose authorized by
the IG Act and other applicable laws and delegations. SWAs must cooperate
with the DOL-OIG.

The DOL-OIG will notify SWAs when the DOL-OIG requires ongoing, recurring,
or regularly-scheduled access to SWA electronic information or data. The DOL-
OIG will use DOL-OIG Form 202, Notification of DOL-OIG Requirement for State
Workforce Agency Electronic Information, to notify SWA Administrators of
specific access requirements. Using DOL-OIG Form 202, the DOL-OIG will
describe the needed electronic information, DOL-OIG user access, or both.

This process does not affect the DOL-OIG’s ability to obtain information using
other established means, including DOL-OIG’s ad hoc, single requirements to
access information systems or obtain data. The DOL-OIG’s access to a SWA’s
electronic information does not change its ownership status. SWA information
remains the property of the SWA.

In obtaining and handling the information, the DOL-OIG will:

      1. Comply with federal system and data security safeguards, including
         Privacy Act, FISMA, NIST, applicable Executive Orders and OMB
         guidelines.
      2. Only access such data and information when necessary for a purpose
         authorized by the IG Act and other applicable laws and delegations, and
         comply with DOL-OIG internal procedures and directives regarding
         necessary approvals for, access to, and handling and securing of
         electronic information.
      3. Redisclose data and information only when necessary for purposes
         consistent with the IG Act, Privacy Act, and other applicable federal laws
         and regulations as they relate to executive branch agencies in the
         disclosure of confidential or sensitive information.
      4. When required, provide SWAs with DOL-OIG’s Interconnection Security
         Standards to ensure secure data access or transfer.
      5. Not take any action to compromise system or user operation and
         performance or create cybersecurity risks to information systems; and

   promptly cease access to at-risk systems and notify the system owner
   when DOL-OIG becomes aware of any such compromise or risk.

6. Complete appropriate training or obtain SWA guidance to understand
   information in their information systems for user accounts; and to the
   greatest extent possible, use the program agency system documentation.
7. Erase/destroy copied data, records, and information when the DOL-OIG
   no longer needs it, in accordance with applicable federal laws and
   guidelines.
8. Promptly notify SWA system owners when DOL-OIG user account holders
   can be removed.

                       UNITED STATES DEPARTMENT OF LABOR
                          OFFICE OF INSPECTOR GENERAL


                            NOTIFICATION OF DOL-OIG
                       REQUIREMENT FOR STATE WORKFORCE
                           AGENCY (SWA) INFORMATION

1. TO:




The SWA Administrator may forward this Notification to the appropriate Information
System point of contact.

The Office of the Inspector General, U.S. Department of Labor (DOL-OIG) needs the SWA
electronic information described below for the performance of Inspector General
responsibilities in accordance with the Inspector General Act of 1978. SWAs must cooperate
with the DOL-OIG on UI-related audits and investigations.


2. Description of Electronic Information or System: (The DOL-OIG may attach
   additional information on required data elements, recurrence of data transfers, or
   interconnection security standards.)




3. Obtain/Transfer Method: User Accounts for Ongoing System Viewing/Retrieval


4. DOL-OIG Main Point of Contact:




5. Name(s) and Title(s) of DOL-OIG Personnel for System Accounts, if applicable:

6. Information/System Due by (date):


The DOL-OIG will:


•   Comply with federal system and data security safeguards, including Privacy Act,
    FISMA, NIST, applicable Executive Orders and OMB guidelines.
•   Only access such data and information when necessary for a purpose authorized by the
    Inspector General Act and other applicable laws and delegations, and comply with OIG
    internal procedures and directives regarding necessary approvals for, access to, and
    handling and securing of electronic information.
•   Redisclose data and information only when necessary for purposes consistent with the
    IG Act, Privacy Act, and other applicable federal laws and regulations as they relate to
    executive branch agencies in the disclosure of confidential or sensitive information.
•   When required, provide SWAs with DOL-OIG’s Interconnection Security
    Standards to ensure secure data access or transfer.
•   Not take any action to compromise system or user operation and performance or create
    cybersecurity risks to information systems; and promptly cease access to at-risk
    systems and notify the system owner when OIG becomes aware of any such
    compromise or risk.
•   Complete appropriate training or obtain SWA guidance to understand information in
    their information systems for user accounts; and to the greatest extent possible, use the
    program agency system documentation.
•   Erase/destroy copied data, records, and information when the DOL-OIG no longer
    needs it in accordance with applicable federal laws and guidelines.
•   Promptly notify SWA system owners when DOL-OIG user account holders can be
    removed.

7. Issued By:




8. TO BE COMPLETED BY STATE ADMINISTRATOR OR DESIGNEE. RETURN THIS TO
DOL-OIG.
The specified information, data, or system access was provided
to                                   , on                   .

I certify that the information provided to the DOL-OIG is accurate, complete, and true to the
best of my belief and knowledge.



___________________________________
Signature


___________________________________
Name of State Administrator or Designee