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Report Unemployment Insurance Fraud

This form is to report unemployment insurance (UI) fraud against the Department of Labor and/or identity theft related to UI. The information you provide in this form will remain confidential. If you are reporting an individual or business for fraud, you may remain anonymous. However, we would like to contact you if we need more information. Thank you for helping us fight fraud.

* Indicates required fields

Please fill out this form to the best of your ability.

Are you reporting UI fraud that is related to identity theft, including someone filing a false claim using your personal information? *
What is the type of fraud you are reporting? *
You indicated that you may be a victim of identity theft related to unemployment insurance (UI), which is a type of UI fraud. Please answer all the following questions and submit your form. We will contact you as soon as we can. Note: This is a secure form and all information submitted will remain confidential.
Is the fraud still happening?*
Please include your contact information if you are willing to be contacted.
Please provide the following information:

Your Contact Information

Your Phone Number*
( ) -
Your Address*
Your Social Security Number*
- -
Please provide all information requested on this form. Your Social Security Number is required in order for the Department of Labor to determine whether a fraudulent claim has been filed in your name – we will not be able to process your complaint without it. All information provided on this form is strictly confidential and secure.

Vehicle

Address of person's current employer

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