Request New or Duplicate 1099-G

If you are in need of a new 1099-G from the Department of Labor either because you need a copy or never received a 1099-G, please complete this form.

Claimant Information

First Name

Last Name

SSN (Last 4 Digits ONLY)

Phone

Date of Birth

Request for Duplicate

Reason for Request

Copy/Duplicate

Never Received

Select the 1099-G form(s) for which you are requesting

(2021) 001-UI: Unemployment Insurance (UI) benefits received in 2021, including extended benefit weeks and FPUC.

(2021) 003-LWA: Lost Wage Assistance (LWA) benefits received in 2021. This federal program provided an additional $300 per week to eligible claimants.

(2020) 001-UI: Unemployment Insurance (UI) benefits received in 2020, including extended benefit weeks and FPUC.

(2020) 003-LWA: Lost Wage Assistance (LWA) benefits received in 2020. This federal program provided an additional $300 per week to eligible claimants.

Other

If you selected 'Other' please specify which 1099-G you are looking for, including the program name and benefit year (2021, 2020, etc.)

Looking to request a PUA (002) 1099-G tax form? PUA Claimants are able to access their 1099-G forms electronically. Login to your PUA Claimant Portal to view/download.

Mailing Address

Please provide the mailing address where you would like your new document sent.

If you believe the address the Department has on file to be incorrect, or different from your current address, please complete the Claimant B-2 Change of Address form. Download and print form here: https://labor.vermont.gov/document/b-2-claimant-change-address-form-printable

Street or P.O Box

City

State

Zip Code

Upload completed B-2 Change of Address form

One file only.
2 MB limit.
Allowed types: pdf.

Certification

I certify that I am the claimant represented by the information provided above or that I have permission from the claimant to submit this request on their behalf.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.