North Dakota Unemployment Determination Appeal Request
NORTH DAKOTA UNEMPLOYMENT DETERMINATION APPEAL REQUEST
Before sending: N.D.C.C. § 52-06-13 gives a party 12 days after a determination notice was mailed to the party's last known address to file an appeal with the appeal tribunal. If the notice was not mailed, the period runs from service instead. Job Service North Dakota says to file by the deadline on the notice and accepts a detailed written appeal through claimant UI ICE, in person, by claimant fax, or by mail. Keep a copy and proof of timely filing.
Date: [__/__/____]
To: Appeals Section, Job Service North Dakota
Mail: P.O. Box 5507, Bismarck, ND 58506-5507
Claimant fax: 701-328-2728
Claimant legal name: [________________________________]
Mailing address: [________________________________]
Phone for hearing: [________________________________] Email: [________________________________]
Claim or determination number: [________________________________]
Date on determination: [__/__/____]
Date notice was mailed or served: [__/__/____]
Appeal and hearing request
I appeal the unemployment determination identified above and request a hearing before the appeal tribunal. I disagree with the determination for these reasons:
[____________________________________________________________]
[____________________________________________________________]
Facts or corrections supporting the appeal:
[____________________________________________________________]
[____________________________________________________________]
Documents available: ☐ Determination ☐ Pay records ☐ Separation records ☐ Messages ☐ Other: [________________]
In-person hearing requested, if applicable: ☐ Yes ☐ No. Reason or access need: [________________________________]
Please send hearing notices and the decision to the contact information above. I will update Job Service if my address or telephone number changes.
Claimant signature: [________________________________] Date: [__/__/____]
Submission record
Method: ☐ Claimant UI ICE ☐ Fax ☐ Mail ☐ Delivered to Job Service office
Date and time filed: [________________________________]
Confirmation or proof retained: [________________________________]
Sources
About this template
- Last updated
- October 27, 2026
- Citations checked
- October 27, 2026
- Jurisdiction
- North Dakota
- Category
- Employment & HR
Legal authority
- N.D.C.C. § 52-06-13 (appeal from determination)
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.
N.D.C.C. § 52-06-13 (checked October 27, 2026): "may file an appeal from such determination with the appeal tribunal within twelve days after the date of mailing of the notice to the person's last-known address"
Job Service North Dakota, What if I Disagree with a Job Service Decision? (checked October 27, 2026): "All requests must be filed with the Appeals Section of Job Service North Dakota on or prior to the deadline date listed in your notice, determination or decision."
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