ET-5901 Form Local Employer / State Employer Income Continuation Insurance Report of Employment and Earnings Employers, complete this form to notify ETF of a claimant’s change in work status and/or earnings paid to the individual after the elimination period.
ET-4560 Form Active Employee / Local Employer / State Employer USERRA Certification Once an employee returns to work with his or her pre-military leave of absence employer, the employer is required to submit this form along with a copy of the appropriate military paperwork.