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Unemployment Publications and Forms

Employers: Tax Publications and Forms

Benefits Publications

Benefits Forms

 

Form #
Form Name and Description
B-9.2 Initial Claim Form with Instructions
Printable application form for New Unemployment Claims.
B-9.3 Verification of Earnings
This form allows an employer to verify a claimant's weekly earnings
B-100 Weekly Claim Form
This Weekly Claim form is provided as a substitute claim form only. It can be used only when authorized by the Bureau of Unemployment Compensation. You must be a currently active claimant to use this form.
B-101 Work Search Log
This form is used to record weekly work search contacts for a five-week period. After five weeks, notification goes to the claimant to return the completed Work Search Log. If a claimant returns to work, the Work Search Log should be returned immediately to the UC Claims Center.
B-4A How to File Your Weekly Benefit Claim (Me. B-4A)
Instructions on how to file weekly claims for unemployment benefits.
W-4V Income Tax Voluntary Withholding Form
Provides for the voluntary withholding of state and federal income taxes from Unemployment Compensation. Includes I-5 Instruction sheet.
I-1 Unemployment Poster (Me. I-1)
Employers required to provide unemployment compensation coverage for their employees must post this notice.
I-3 Benefits Rights Booklet - What Every Worker Should Know
What Every Worker Should Know About Unemployment Benefits (Information about every claimant's rights and responsibilities)
B-70 Dependents Claim Form
Information required to claim a dependency allowance.
B-7 Alien Verification Form
Information required to verify Alien Status for non-citizens and request for copy of alien card.
ETA-858A (1) Weekly Request for Allowances
Weekly Request for Allowances Only - Daily Travel/Subsistence for Trade Readjustment Allowances and North American Free Trade Agreement Programs.
B-100 (DWB) Dislocated Worker Benefits Weekly Claim Form
Verification of attendance at training for Dislocated Worker Benefts claims.
DWB-1 Dislocated Worker Benefits
Initial Application for Dislocated Worker Benefits.
B-100 (MEO) Weekly Claim - MEO
Weekly Claim and Log of Self-Employment Activities for the Maine Enterprise Option Program.
I-23 TRA Trade Readjustment Assistance Act - Work Search Requirements
Explanation of Work Search and Suitable Work Requirements under the Trade Readjustment Allowances and North American Free Trade Agreement Programs.
MEO-13 Maine Enterprise Option Info Pamphlet
Informational pamphlet that explains eligibility requirements for benefits while entering self-employment.
MEO-14 Maine Enterprise Option
List of approved training programs for participants in the MEO program.
UC-3 Request for Commission Hearing for Income Tax Refund Offset
Used to request a commission hearing when an Income Tax Refund is being offset.
UIC-1 Overpayment Waiver Information
Information on how to request a waiver of an unemployment benefit overpayment through the Unemployment Insurance Commission.
B-170 Application for Direct Deposit
Unemployment benefit checks can be direct deposited into your checking or savings account. Use this application to start or stop direct deposit.
ETA-858A (2) Weekly Request for Allowances and Attendance Form for TAA/TRA
Weekly Request for Benefits and/or Daily Travel/Subsistence Allowances (combined form) for Trade Readjustment Allowances and North American Free Trade Agreement Programs
MEO-10 MEO Survey / Withdrawl Form
Informational survey/withdrawal form that will assist us in evaluating the reasons for withdrawing from the MEO program and the program's effectiveness.
MEO-8 MEO Record of Education and Counseling
Issued after participant is accepted into MEO program. A record of education and counseling component verification. This form is returned to LEC at CareerCenter once Introduction to Business and Counseling appointments have been completed.
FD-1 Reporting Potential Unemployment Fraud
You can report instances of unemployment fraud by using this form.
B-2 (EUC08) Emergency Unemployment Compensation 2008 (EUC08) Application
This form is used to file for Emergency Unemployment Benefits (EUC08)
B-100 (EB) (Web) Extended Benefits (EB) Weekly Claim Form
Weekly Claim Form for Extended Benefits (EB).
I-23 (EB) Information Sheet Regarding Extended Benefits (EB)
This form provides an explanation of the Extended Benefits (EB) work search and suitable work requirements under the Maine Department of Labor Employment Security Law
B-17 (Web) Request for Approval of Training
Use this form to request approval of training programs.
TRA-17A Trade Readjustment Assistance Act (Brochure A)
Explanation of benefits and allowances available for Trade Readjustment Allowances and the Trade Adjustment Assistance Programs. (For Trade Certifications Numbered 50,000 - 69,999 or 80,000+)
TRA-17B Trade Readjustment Assistance Act (Brochure B)
Explanation of benefits and allowances available for Trade Readjustment Allowances and the Trade Adjustment Assistance Programs. (For Trade Certifications Numbered 70,000)