certify benefits

• During the week ending 9/5/2010, I did not refuse any job offer or job referral.
• Including self-employment, I did not work during the week ending 9/5/2010,
• Excluding earnings from self-employment, I did not earn more than $405.00.
• I was ready, willing and able to work every day last week.
• I was not owed vacation pay and I did not receive vacation pay.
• I was not owed holiday pay and I did not receive holiday pay.
• I have not returned to work full time.