Skip to main content
An Official
Vermont
Government Website
State of Vermont
Department of Labor
Menu
Home
About Us
Contact Us
Reports and Publications
Calendar of Events
Unemployment Insurance
Workforce Development
Labor Market Information
Workers’ Compensation
Workplace Rights & Wages
Workplace Safety
Vermont Occupational Safety and Health Administration (VOSHA)
Passenger Tramway
Project WorkSAFE
VT RETAIN
Additional Support Services
Equal Opportunity & Non-Discrimination
Search
Submit
Breadcrumb
Home
Home
About Us
Contact Us
Reports and Publications
Calendar of Events
Unemployment Insurance
Workforce Development
Labor Market Information
Workers’ Compensation
Workplace Rights & Wages
Workplace Safety
Vermont Occupational Safety and Health Administration (VOSHA)
Passenger Tramway
Project WorkSAFE
VT RETAIN
Additional Support Services
Equal Opportunity & Non-Discrimination
Report Fraud Related to 1099-G
You must have JavaScript enabled to use this form.
If you recevied a 1099 from the Department of Labor but never filed for, or received, unemployment benefits during the 2021 calendar year, please complete this report.
Claimant Information
First Name
Last Name
SSN (Last 4 Digits ONLY)
Phone
Email
Date of Birth
1099 Info
Which 1099-G forms did you receive (select all that apply)
001-UI
002-PUA
003-LWA
Additional Information
Doc Upload
Upload any relevant documentation pertaining to this case.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf.
Certification
Yes
I certify that I did not file for unemployment insurance benefits through the State of Vermont during the 2021 calendar year. Any claim that was opened and/or paid in my name should be considered fraudulent. Furthermore, I understand that falsely obtaining benefits is a crime and subject to prosecution.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Leave this field blank
