Complete The Section Below If You Are A Claimant:

---

• All appropriate items must be completed.
  
• If identifying information cannot be provided, we cannot process claims related requests via email. You must make your request via telephone to the inquiry line at 1-800-361-4524.
  
• Due to the increased volume of emails, an immediate resolution may not be possible. Please allow a minimum of three (3) days. We also suggest you continue calling the UC Telephone Inquiry line at 1-800-361-4524.
  
• All questions marked with an asterisk (*) are required.
  
• Please note that the Alabama Department of Labor is prohibited from providing confidential unemployment claims information to anyone other than the claimant. Any individual who makes a false statement or representation in connection with an unemployment benefits claim can be found guilty of unemployment fraud and subject to legal prosecution.
  

---

I certify that I am the claimant indicated below.  I understand that the law provides penalties for making false statements or any misrepresentation to obtain unemployment benefits.  * I agree   

Date:  03/12/2014  

---

*Full Name:  (As it appears on claim)
*SSN: (Last 4 Digits)
*Mother's Maiden Name:
*Driver's License or ID #:  (Last 4 Digits)
Email:
*Contact Phone: (if we need to call you)
*Subject:	Select A Subject How To File A Claim How To Report Earnings How To Report School Attendance How To Reopen A Claim How To Obtain Copies of Records Extended Benefits Eligibility Report Fraud Other (Please Explain)

*Comment or Question: 

* File a Claim
* File Weekly Certifications
* View Status of Weekly Certifications
* Change Your Address
* Change Benefit Payment Option
* View 1099 Tax Document
* Obtain General Information
* View Benefit Rights and Responsibilities Booklet