Submit this form via Massachusetts UI Online at www.mass.gov/dua or call the TeleClaim Center at 877-626-6800. You may also visit a One-Stop Career Center to use publicly available computers for online submission. Ensure all required fields are filled out accurately, and have your personal and employment information ready for verification. Avoid delays by submitting your application promptly within the first week of job separation or reduction in work hours.

For 2024 and 2025, important dates include the first week after job separation to apply for benefits. Ensure weekly benefit requests are made on Sundays to avoid delays.

The purpose of this form is to guide individuals in applying for Unemployment Insurance (UI) benefits in Massachusetts. It provides comprehensive instructions on eligibility, application procedures, and necessary documentation. By following this guide, applicants can efficiently navigate the UI benefits process and receive the financial support they need during periods of unemployment or reduced work hours.

• 1. Social Security Number: Your unique identifier for state records.
• 2. Date of Birth: The exact date you were born in month, day, and year format.
• 3. Home Address: Your current residential address.
• 4. Telephone Number: Your contact number for communication.
• 5. Email Address: Optional, used for electronic communication.
• 6. Previous UI Claim: Details if you’ve filed a UI claim in Massachusetts or another state in the past 12 months.
• 7. Employment History: Names and addresses of employers from the past 15 months, with dates worked.
• 8. Military Discharge Papers: Form DD-214 if you separated from military service within the past 18 months.
• 9. Federal Employment Separation: Form SF-8 or SF-50 if you've worked for the federal government recently.
• 10. Reason for Unemployment: Explanation of why you are no longer working or why your hours were reduced.
• 11. Last Day of Employment: The final date you worked at your last job.
• 12. Dependent Information: Details of dependent children, if you're claiming them.
• 13. Alien Registration Number: Proof of eligibility to work in the United States if applicable.

Failing to submit this form can lead to delays or denial of Unemployment Insurance benefits. It is essential to complete and submit the form promptly to ensure you receive the support you need.

• Delay in Benefits: You may not receive timely payments if there is a delay in submission.
• Denial of Claim: Incomplete or late submission may lead to your claim being denied.
• Unpaid Weeks: Missed weeks of eligibility may result in unpaid or lost benefits during the period of unemployment.

• 1. Job Separation: Use this form immediately after losing your job to apply for UI benefits.
• 2. Reduced Hours: Apply with this form if your hours have been significantly reduced.
• 3. Interstate Claims: If you moved out of Massachusetts but worked there, file an interstate claim.
• 4. Military Separation: File for benefits if you've been recently discharged from military service.
• 5. Federal Employment Separation: Use this form if you recently separated from federal government employment.