UI Applicant Questionnaire

Document Number:  UCB-15465-E

Description:  This form is used to collect applicant information to help facilitate the interview process in the Unemployment Insurance Division, Bureau of Benefits.

Comments:  Form is protected from modification and enabled for form fill (includes tabbed fields for form completion).  This form is mailed to the UI Applicant and can be completed by hand.  A printed copy of this form should be brought to the interview.

Content Contact:  Benefit Operations Staff

Document Attachment:  UCB-15465-E (Word/72 KB)

*** If you need to access this form in an alternate format, please send an email to the Content Contact listed above.

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