PUA-User Info

This form should be used only by claimants who wish to have their PUA and PUA-related FPUC unemployment compensation benefits again paid by check. Checks will be sent via regular first class mail, and generally arrive four to six business days following the day of filing. Please be aware, however, that the enormous volume of benefits payments resulting from the coronavirus pandemic has placed extraordinary demands on both the Department of Labor and Industry and the Treasury Department. There have been recent instances where these challenges resulted in unpredictable delays and interruptions, frequently in the production and mailing of benefits checks. Delivery of checks in the future is subject to similar uncertainties. If you wish to have your benefits sent by check, please complete and submit the information identified below. If you do not complete and submit the form, your benefits will automatically continue to be paid through deposits on the debit card that was recently mailed to you. Deposits will generally post to the debit card on the third business day after filing for benefits.

Claimant Information

Last Name

Please enter Last Name

First Name

Please enter First Name

SSN xxx-xx-xxxx

Please enter Social Security Number

Date Of Birth

Please enter Date of Birth

Address

Please enter Address

Additional Address

City

Please enter City

State

Zip

Please enter Zip Code

Phone xxx-xxx-xxxx

Please enter Phone

Please enter Email

I wish to receive my PUA and PUA-related benefits by check

* Required Fields

FOR PUA CLAIMANTS WHO WISH TO REINSTATE BENEFITS PAYMENTS BY CHECK