Unemployment Assistance

In order to better assist you, please fill out this form completely. The more information we have, the sooner we can submit your request to the Pennsylvania Department of Labor and Industry. If you have any questions, please call our office at 610-929-2151.

Unemployment

First Name *

Last Name *

Phone Number *

Email *

Address *

Address 2

City *

State *

Zip Code *

Your full Social Security Number

What is the first date of your claim? *

Did you file for Traditional Unemployment or PUA? *

Are you missing payments? *

Yes

What weeks are you missing? Please list exact dates.

Were you receiving payments and then they stopped? *

Yes

What date did they stop?

Have you checked your payment history? *

Yes

Does it say “pending” or “no payments made”? *

Pending

No Payments Made

Did you quit, get fired or get laid off? *

Quit

Fired

Laid off

Is your claim under review? *

Yes

Not Applicable

Name of employer as it appears on paycheck stub or are you self-employed? *

Has the Department of Labor requested information from you? *

Yes

Have you sent the information requested to the Department of Labor? *

Yes

Please describe your issue: *

If you are human, leave this field blank.

How Can I Help?

→ Applications & Forms
→ Business Toolkit
→ Expenses
→ Grant & Resource Directory
→ Home Heating Assistance
→ Internship Program
→ Toll-Free Phone Numbers
→ Useful Links

District Office

210 George Street
Suite 201
Reading, PA 19605
Phone: (610) 929-2151
Fax: (610) 929-2576

Harrisburg Office

457 Main Capitol Building
Senate Box 203011
Harrisburg, PA 17120-3011
Phone: (717) 787-8925
Fax: (717) 772-0578

Facebook
X
Instagram
RSS