Montana Unemployment Determination Appeal Request
MONTANA UNEMPLOYMENT DETERMINATION APPEAL REQUEST
Before sending: Under Mont. Code Ann. § 39-51-2402(3), apply for reconsideration or appeal within 10 days after the determination or redetermination was sent to your address of record. The statute permits an extension for good cause. The Unemployment Insurance Division's handbook tells claimants to follow the filing instructions on the specific notice and to keep requesting weekly payments while review is pending. This document concerns the initial determination or redetermination, not an appeals-referee or Board decision.
Date: [__/__/____]
To office and address or submission channel printed on determination: [____________________________________________________________]
Claimant name: [________________________________]
Address of record: [________________________________]
Phone: [________________________________] Email: [________________________________]
Claim or issue number: [________________________________]
Determination or redetermination date: [__/__/____]
Date it was sent to address of record, if known: [__/__/____]
Request — select one
☐ Reconsideration. I ask the Department to reconsider the determination described above. I provide the new or corrected facts below.
☐ Appeal. I appeal the determination or redetermination described above and request a hearing before an appeals referee under Mont. Code Ann. § 39-51-2403.
I disagree with the decision because:
[____________________________________________________________]
[____________________________________________________________]
Facts or corrections supporting my request:
[____________________________________________________________]
[____________________________________________________________]
Documents available: ☐ Determination ☐ Pay records ☐ Separation records ☐ Messages ☐ Other: [________________]
If submitted after the 10-day period, facts showing good cause for the delay: [________________________________________________________________ / NOT APPLICABLE]
Please notify me of the decision or hearing arrangements using the contact information above. I will update my address if it changes.
Claimant signature: [________________________________] Date: [__/__/____]
Submission record
Submission route specified on the determination: [________________________________]
Date and time sent or delivered: [________________________________]
Confirmation or proof retained: [________________________________]
Sources
About this template
- Last updated
- October 27, 2026
- Citations checked
- October 27, 2026
- Jurisdiction
- Montana
- Category
- Employment & HR
Legal authority
- Mont. Code Ann. § 39-51-2402(1)-(3) (determination and initial appeal)
- Mont. Code Ann. § 39-51-2403 (appeals referee hearing)
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on October 27, 2026.
Mont. Code Ann. § 39-51-2402(3) (checked October 27, 2026): "A determination or redetermination is final unless an interested party applies for reconsideration of the determination or appeals within 10 days after the determination or redetermination was sent to the interested party's address of record."
Mont. Code Ann. § 39-51-2403 (checked October 27, 2026): "Upon appeal of a determination or redetermination under 39-51-2402, an appeals referee shall hold a hearing, which may be conducted by telephone or by videoconference."
Montana Unemployment Insurance Division, Claimant Handbook (December 2025), Appeal Process (checked October 27, 2026): "Carefully read each notice of determination, redetermination, or hearing decision you receive for specific instructions on how to file a further appeal."
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