WARN Act or Dislocated Worker Notifications

The purpose of this form is to provide layoff, closure or reduction in force notifications to the District of Columbia's Chief Elected Official and State Dislocated Worker Unit. When utilizing this form, you acknowledge that completion of this form is an effort to comply with the following applicable federal requirements:


Worker Adjustment Realignment and Notification (WARN) Act, 29 U.S.C. § 2107(a), and its implementing regulations, 20 CFR Part 639 for private and nonprofit employers, where applicable; and


5 U.S.C. § 3502(d) and its implementing regulations, 5 CFR. § 351.803(b), for federal government agencies.


Please enter the name of your business or organization.

Please enter the total number of indivdiuals for separation based on the notice you are submitting

Please enter the specific date or date range of separations. If there are multiple dates, a statement such as " various dates through 12/31/2020" will suffice.


Please upload your file in a PDF (preferable) or Word Format.

Drag and drop files here or