INSTRUCTIONS: ARIZONA FINAL NOTICE TO EMPLOYER OF REFERRED WORKER (Form ESA-1257A)

Arizona employers may submit a form JBS-1028A if they wish to place public notice of a job opening through the state Department of Economic Security through its employer services division. A form ESA-1257A will be sent if it is determined by the federal government that a worker referred to this job is not qualified to work in the United States. This document can be found on the website maintained by the Arizona Department of Economic Security.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 1: In the first blank box, the applicable job order number will be entered.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 2: In the second blank box, the applicable employer number will be entered.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 3: In the third blank box, the applicable employer address will be entered.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 4: In the blank box in the next paragraph, the date on which you were initially referred a worker will be entered. The remainder of the paragraph explains the eligibility verification process.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 5: The next sentence states that the individual has now been found invalid to work in the United States.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 6: The next blank line will have the worker in question's name.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 7: The next blank line will have the date of the referral in question.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 8: In the next blank section, the name of the staff member completing this form will be entered.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 9: On the next blank line, the staff member will provide their signature.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 10: In the next blank section, the number of the employment service office will be entered.

Arizona Final Notice To Employer Of Referred Worker ESA-1257A Step 11: In the last blank section, the date of this notification will be entered. Further assistance in understanding this form can be obtained by calling the phone number at the bottom of the page.