EIS Form 7 - Employment Insurance System Application

This is a mandatory form that must be completed to apply for all benefits under EIS

B. Loss of Employment Information

B1. Last Job*

B2. Employment start date with last employer*

B3. Loss of Employment date (LOE)*

B4. Employment status*

B5. Salary Information (6 consecutive months before LOE)*

No.	Month	Year	Salary (RM)

B6. Average working hours in a week including overtime

B7. Cause of Loss of Employment*

B8. Did you receive compensation for Loss of Employment?*

Yes

B9. Did you file your case to the Labour Department, Industrial Relations Department or the Industrial Court?*

Yes

If yes, please state the reference number for the case above*

B10. Do you have any other unregistered Loss of Employment(s)?*

Yes