Language English How can we help? What is your role? * Employee Unemployed Employer Other Support Need * - Select -1099 RequestAppeal: I have a question about my hearing.Appeal: I have questions on my hearing decision. I have questions on backdating my unemployment.Please update my contact info.Debit Card: I am missing payments.Can you help explain my unemployment decision letter.I'm an Employer and I have questions.I have questions about employer statement of charges.I have questions about my fact-finding interview.I have questions about my eligibility for Federal programs.I have questions about Federal Pandemic Unemployment Compensation (FPUC).I have general Fact Finding questions.I have questions about my initial claim.I would like to report Fraud or ID Theft.Payment: I did not receive a payment.Payment: my payment amount was incorrect.Payment: when will I start receiving payments.Payment: inquiry request.I have overpayment questions.Pandemic Emergency Unemployment Compensation (PEUC): waiting for approval.Pandemic Unemployment Assistance (PUA): waiting for approval.Tax withholding questions.I have questions about my weekly claim.Other1099-G Tax Form requests are processed via the 1099-G Request form. Do not proceed, please fill out the correct form. If you have been a victim of identity theft or fraud do not proceed, please fill out the correct form. Online Identity Theft Form Fraud Forms Support Needed - Other * Have you filed an unemployment insurance claim? * - Select -YesNo Legal Name Business Name * First Name * Middle Name Last Name * Address Street Address * Street Address 2 City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Contact Information Phone Number * Email Address * Identity Verification Last 4 Digits of Social Security Number * ###-##- Employer Account Number * Month and Day of Birth * Year188318841885188618871888188918901891189218931894189518961897189818991900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Additional Verification Questions * - Select -What was the last day you worked?What is the name of the last employer you worked for (this may be the same employer that you currently work for)?What was the amount of the last benefit payment you received?How many dependents did you use when you filed on your unemployment insurance claim?What was the start date with your last employer? Verification Answer * Additional Information Comments * Documents Upload More informationFiles must be less than 20 MB. Allowed file types: gif jpg jpeg png pdf doc docx. Leave this field blank Submit Individual
