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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.
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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.
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