Supplemental Unemployment Verification
Employee verification for supplemental unemployment insurance benefits
First Name: *
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Last Name: *
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Employee ID Number *
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Birth Date: *
In North Carolina and Virginia, there are 3 criteria that individuals must meet in order to be eligible for unemployment benefits:
1) You must be unemployed due to no fault of your own.
2) You must be considered monetarily eligible.
3) You must be able, available and actively seeking work
Do you currently meet the criteria outlined above? *
To certify that all of the above answers are true, please enter your initials below. This will serve as your electronic signature. *
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