For my EDD unemployment DE 4581 continued claim form, does anyone have more sample questions ?

For my EDD unemployment DE 4581 continued claim form, does anyone have more sample questions, here is what I got :
Claim History
This page has a summary of your claim history.
For more help view the Continued Claim Form tip sheet
If a certification period (one or two weeks) has a status of:
"Ready to File": You may certify for that period today. Please select the "Continue" button at the bottom of the page.
"Submitted": Your information for that period has already been received. Please allow ten (10) days from the submission date for processing
"Use Paper Form": You must use your paper claim form for this period

If a particular certification period is not listed: Use your paper "Continued Claim" form to certify for that period.
BeginningEndingWeeksStatus
12/05/201012/18/20102Ready to File
11/21/201012/04/20102Issued12/07/2010


Before you file on-line, please answer the following questions:
This continued claim is for the week(s) beginning 12/05/2010 and ending 12/18/2010.
Did you receive any money other than wages (such as vacation, holiday, pension, etc) from any employer during the dates listed above?
Did you serve on Jury Duty during the dates listed above?
Did your employer give you a claim form for the Work Sharing program?
Did your employer or union give you a claim form?
Do you have a training form from an Apprentice Training Provider to submit to EDD?
Do you have a change of address or phone number?
Did you work or earn any money, whether you were paid or not during the dates listed above?



Please answer all questions. Each question is explained in your booklet: A Guide to Benefits and Employment Services.
1ST WEEK2ND WEEK
Begins 12/05/2010Begins 12/12/2010
Ends 12/11/2010Ends 12/18/2010
1.Were you too sick or injured to work?*YesNoYesNo
If yes, enter the number of days (1 through 7) you were unable to work
2.
Was there any reason (other than sickness or injury) that you could not have
accepted full time work each weekday?*
YesNo
YesNo
3.
Did you look for work?*
YesNo
YesNo
4.
Did you refuse any work?*
YesNo
YesNo
5.
Did you begin attending any kind of school or training?*
YesNo
YesNo
6.
You indicated on the previous page that you had no work or wages during this period. If you DID have work or wages, whether you were paid or not, you must mail in a paper claim form. Select the button below "Mail a Paper Claim Form".
7.
If you want federal income tax withheld for the week(s) shown above, mark this block
8.
You indicated on the previous page that you did not have an address change during this period. If you DID have and address change, you must mail in a paper claim form. Select the button below "Mail a Paper Claim Form".

Answer by Livingstone Partners
Yes, you are right : Questions are :
Did you receive any money other than wages (such as vacation, holiday, pension, etc) from any employer during the dates listed above?
Did you serve on Jury Duty during the dates listed above?
Did your employer give you a claim form for the Work Sharing program?
Did your employer or union give you a claim form?
Do you have a training form from an Apprentice Training Provider to submit to EDD?
Do you have a change of address or phone number?
Did you work or earn any money, whether you were paid or not during the dates listed above?

1.Were you too sick or injured to work?*YesNoYesNo
If yes, enter the number of days (1 through 7) you were unable to work
2.
Was there any reason (other than sickness or injury) that you could not have
accepted full time work each weekday?*

3.
Did you look for work?*

4.
Did you refuse any work?*

5.
Did you begin attending any kind of school or training?*
YesNo

What do you think? Answer below!

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Orignal From: For my EDD unemployment DE 4581 continued claim form, does anyone have more sample questions ?