Mass Separations

Employers must provide a Mass Separation Notice (DOL-402 and DOL-402A) to the Georgia Department of Labor (GDOL) when 25 or more workers employed in one establishment are separated on the same day, for the same reason, and the separation is permanent, for an indefinite period or for an expected period of seven days or more.  The forms should be completed using the Mass Separation Notice Instructions (DOL-402i) and submitted within 48 hours of the separation.

Mass Separations - Related Links

  • Mass Separation Notice Instructions - DOL-402i (PDF, 252.38 KB)

    Instructions for Mass Separation Notice DOL-402 and Mass Separation Notice Continuation Sheet DOL-402A, required information and methods to submit.

  • Separation Notice - Mass - DOL 402 (PDF, 195.58 KB)

    Please answer all questions. The printed name, title, signature and contact information of the representative completing the form is required. A separate list should be completed for each set of employees who are separated on different days or for different reasons.

  • Separation Notice - Mass Continuation Sheet - DOL 402A (PDF, 663.56 KB)

    Please provide the requested information, as appropriate, according to the instructions for each section. A separate list should be completed for each set of employees who are separated on different days or for different reasons.