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Form Uc-700 - Pennsylvania Unemployment Compensation - Department Of Labor & Industry

PENNSYLVANIA UNEMPLOYMENT

COMPENSATION

OFFICE OF UNEMPLOYMENT COMPENSATION BENEFITS

Under the provisions of the Pennsylvania Unemployment Compensation (UC) Law, I am registered with the

Pennsylvania Department of Labor & Industry as:

NAME

ADDRESS

EMPLOYER ACCOUNT NUMBER

You may be eligible for unemployment compensation benefits during periods when you are either partially or

totally unemployed through no fault of your own.

IMPORTANT

Your UC application will be dated effective the week in which you actually file the application for benefits. You

should file a new claim or reopen an existing claim during the first week in which you are unemployed or your

hours are reduced. A delay in filing may adversely affect your eligibility for benefits.

NOTE: To file an application for UC benefits, you will need to provide your:

• Social Security Number

• Alien registration number (if not a U.S. citizen)

• Complete mailing and home address

• Name and address of employer(s)

• Dates of employment and reasons for leaving

• Employer information form (if you have one)

• Most recent pay stub (optional, but helpful)

• PIN number (if you have one from a prior claim)

You can file an application for benefits, reopen an existing UC claim or get information about the UC program

online at or by calling the UC Service Center in your area at 888-313-7284. TTY: (Hearing

Impaired) at 888-334-4046.

When claiming UC benefits, you must report gross wages that you earned during any week for which you are

claiming UC benefits. Computer crossmatching is used to detect the illegal receipt of UC payments resulting from

unreported work and earnings, as well as unreported pensions.

REMEMBER: Whenever you have questions or any problem regarding your UC claim, contact your UC Service

Center. Do not rely on outside advice that may be incorrect and could adversely affect your eligibility to receive

UC benefits.

A person who knowingly makes a false statement or knowingly withholds information to obtain UC benefits commits

a criminal offense under section 801 of the UC Law, 43 P.S. §871, and may be subject to a fine, imprisonment,

restitution and loss of future benefits.

Auxiliary aids and services are available upon request to individuals with disabilities.

Equal Opportunity Employer/Program

UC-700 REV 04-13

Form Uc-700 - Pennsylvania Unemployment Compensation - Department Of Labor & Industry