This form is for claimants to report issues with a 1099 that you received from CDLE. If you did not receive unemployment benefits in either 2020 or 2021 but received a 1099 form with your name on it, please complete this form. If you did receive unemployment benefits, but the 1099 form you received shows an inaccurate amount, you should also use this form.  If you received a 1099 form at your address with a name that does not match anyone in your household, please report the situation using this link, which will open in a new tab: CDLE Fraud Prevention.

To ensure a successful and thorough investigation, you should provide as much detail as possible when completing this form.

* Required

The amount in box 1, Unemployment Compensation, on the 1099 is the GROSS amount paid. The gross amount includes withholdings, such as any federal and state taxes and child support taken out. Please review the details on the Payment History of your MyUI+ account before submitting this form.

Your Information
In order for us to fully investigate the 1099-G you received, we need you to provide some information from the form. We may be required to share your information with law enforcement if a criminal investigation begins.

Please provide your SSN. This form is being completed on a secure site connected to MyUI+. We need the SSN from the 1099G you received in order to locate the associated claim.
If you need a corrected 1099 to file your taxes, you must put the entire Social Security Number in this field.

Requestor Address Information
Please be careful when entering your address below, and only enter the information asked for (only put your house number in the 'house number' box, only put your zip code in the 'zip code' box, etc.)

When we mail out any corrected 1099, it will go to the address you enter below. Make sure to provide a current, correct address at which you would like to receive your 1099. If you enter anything other than address information in these boxes, we will not be able to supply you with a replacement 1099 form.

Or type 'PO Box' if your mailing address is a post office box.

Or your PO Box number if your mailing address is a post office box.

Make sure to just enter your street number and street name in this box (such as 1234 Any Street) or Post Office Box and number (such as PO Box 1234) and NOT your city, state, and zip code. You will enter your city, state, and zip code in the boxes further down on this form. When we mail out any corrected 1099, it will go to this address. Make sure to enter the address at which you would like to receive your 1099.

(This name will appear in addition to your name on any correspondence mailed.)

Individual You Suspect of Using Your Identity
If you know any details about this individual, please complete as many of the following fields as possible (Name is required).

Enter the first name of the person suspected.

Enter the last name of the person suspected.

This text box helps to prevent spam and ensures that only humans are submitting this form

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