Eng 4055 Form 2012-2024

Eng 4055 Form: What You Should Know

This form is also used by the Department of Justice (DOJ) to file a complaint against a State employee by mail when the employee does not present a valid IDS. A copy of this form can be obtained from the clerk of the Board of Review (CBB) in Circuit Court. Note: When you pay by check or money order, no additional payment is requested unless the check has been dishonored. Payment by telephone or cash will not be accepted. [Order Form DC-4055] Note: A copy of this form is mailed by the BB to the employee who is to be the subject of the request. 125.01 Notice of Change of Address: Service of Process on an Employee — Board of Review [Order Form DC-4056] Note: This form is used by the employer to inform an employee of a new address. A copy of this form is mailed by the BB to the employee who is to be the subject of the request. 125.02 Notice of Change of Address: Service of Process on an Employee — Virginia Personnel Board of Review [Order Form DC-4055] Note: This form is used by the employer to inform an employee of a new address. A copy of this form is mailed by the BB to the employee who is to be the subject of the request. 125.03 Notary Public's Statement: Declaration Concerning Tax Exempt Status — [Order Form DC-4066] Note: This form is used by the employer to notify the employee that a notary public's statement has been entered as a witness document. A copy of this form is mailed by the BB to the employee who is to be the subject of the request. 125.04 Statement of Account — Board of Review / Civil Board of Appeals [Order Form DC-4066] 125.05 Notice of Service Upon Claimant for Unemployment Benefits — [Order Form DC-4057] Note: This form is used by the employer to notify the employee that a judgment is issued and that it is to be served upon the employee by certified mail. A copy of this form is mailed by the BB to the employee who is to be the subject of the request. 125.

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