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Document Number: UCB-19359-E
Description: Claimants may use this form to authorize a time-limited release of their Unemployment Insurance records to an agent.
Comments: Unemployment Insurance records and information concerning claimants are confidential under state and federal law and can only be disclosed under very specific circumstances. DWD can release claimant records to the claimant, but cannot discuss the records, their content, nor the claim with an agent without a signed release from the claimant.
Content Contact: UI Communications Liaison
Document Attachment: UCB-19359-E (pdf/661 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
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