REPORT UNEMPLOYMENT IDENTITY THEFT: FOR INDIVIDUALS

Important Information

Use this form for all suspected unemployment identity theft. If you have received a Reliacard debit card or other correspondence from the Colorado Department of Labor and Employment (CDLE), but you have not filed an unemployment claim, please report it to us via this form. Use this same form if you have received any correspondence to your mailing address that was sent to someone else other than those in your household.

(The exception would be if you have received a 1099 form in your name, and you either did not file for unemployment benefits, or the amount of benefits received on the 1099 form is inaccurate. If that is the case, please report those 1099 tax form issues at this link, which will open in a new tab: Report Invalid or Inaccurate 1099.)

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

Please note that this form is specifically for Colorado state UI claims. If someone has stolen your identity and used it to file an unemployment claim in a different state, you must report it to that state's unemployment division.

Enter your primary contact information here, including a current email address where you can be reached. We may contact you for a follow-up if necessary. Please understand that while it is important to keep your information confidential, we may be required to share your information with law enforcement if a criminal investigation begins.

Your First Name

Your Last Name

Your Phone Number

Your Email Address

What type of identity theft are you reporting? (If unsure, see below for notes)

Identity Theft Type

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Notes:
If the card or correspondence you received is in your maiden name, select 'My Identity was used to file an unemployment claim'.
If you are an employer but the card or correspondence is in your name, select 'My identity was used to file an unemployment claim'.

My Identity Was Used to File an Unemployment Claim

Did you previously receive benefits and now believe that claim has been compromised?

YesNo

What was the last month during which you requested unemployment benefits?

Are you a Federal employee furloughed as a result of the federal shutdown?

YesNo

Your Claim Information

We will need some additional personal information in order to locate any potential claim using your identity.

If you received a piece of correspondence addressed to a name different than your own, please enter the name as it appears on the correspondence:

This may be different from the way your name is usually written. Sometimes, the claim will be filed with the last name as the first name and the first name as the last name, or it may have been filed using your maiden name. If there is a middle initial, please include that as well.

Your Date of Birth

Make sure to include forward slashes ('/') between the month, day, and year, like so: MM/DD/YYYY

Your Full Social Security Number

Your Claimant ID

(Optional) If any correspondence you received includes a 'Claimant ID' (usually found under the date near the top of the form), please include that number here.

This is an eight-digit number that usually starts with either a '1' or a '2'. There should be no special characters or punctuation marks.

Your Street Address (or Mailing Address)

Please only put the house number and street name (or PO Box) in this field. You will add the city, state, and zip below.

Your City

Your State

Your Zip Code

I Know of Someone Collecting Unemployment Benefits While Working

Suspected Individual's InformationPlease provide information about the person suspected of committing working while collecting unemployment insurance benefits. Complete as many of the following fields as possible. All the information in this section refers to the person suspected.

Name of Business or Employer

Enter the name of the business or place of employment at which the individual is working while collecting benefits.

Employer's Phone Number

Employer's Mailing Address/Street Address

Please only put the house number and street name (or PO Box) in this field. You will add the city, state, and zip below.

Employer's City

Employer's State

Employer's Zip Code

Worker's First Name

Enter the first name of the person suspected.

Worker's Last Name

Enter the last name of the person suspected.

Worker's Phone Number

Enter the phone number of the person suspected.

Worker's Date of Birth

Enter the date of birth of the person suspected.

Worker's Social Security Number

Enter the social security number of the person suspected.

Worker's Mailing Address/Street Address

Please only put the house number and street name (or PO Box) in this field. You will add the city, state, and zip below.

Worker's City

Worker's State

Worker's Zip Code

I Know of Someone Collecting Unemployment Benefits While Working

Please enter the name as it appears on the card or correspondence:

This may be different from the way your name is usually written. Sometimes, the claim will be filed with the last name as the first name and the first name as the last name. If there is a middle initial, please include that as well.

(Optional) If there is a 'Claimant ID' included with the card or correspondence, please include that here:

The 'Claimant ID' is an eight-digit number that usually starts with either a '1' or a '2'. There should be no special characters or punctuation marks.

Street Address from ReliaCard (or other correspondence) Envelope

Enter the mailing address as it appears on the envelope in which you received the Reliacard or correspondence.

Please do not enter the return address from the envelope (the one in the upper left corner). Enter the mailing address (the one in the middle of the envelope).

City from ReliaCard (or other correspondence)
Envelope

State on ReliaCard (or other correspondence)
Envelope

Zip Code from ReliaCard (or other correspondence)
Envelope

I received a suspicious text or email message about my unemployment claim.

Did you click on the link in the message?

YesNo

Are you still able to access your MyUI+ account?

YesNo

Please immediately go and change your MyUI+ password, if you haven't already. This is crucial to prevent unauthorized access to your account.

We will investigate your claim to find out if it has been hijacked, and take appropriate action if so (up to and including locking the account to prevent access). We will need your MyUI+ claimant id in order to complete this investigation:

MyUI+ Claimant ID

This is an eight-digit number that usually starts with either a '1' or a '2'. There should be no special characters or punctuation marks.

Provide Details About Suspicious Message Received

Are you able to upload a photo or screenshot of the message you received?

YesNo

Upload your photo or screenshot here:

The following file formats can be uploaded: .bmp, .gif, .jpg, .jpeg, .png, .tif, .qtf

Please provide all of the details of the message you received, including the exact wording, the date and time the message was received, and the phone number or email address it was sent from.

What is the first letter in the word "Colorado" ?

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Please confirm this statement by checking the box below.

I certify that I have answered the questions in this form truthfully. I understand that there are penalties for providing false or misleading information.

Yes, I agree

REPORT UNEMPLOYMENT IDENTITY THEFT: FOR INDIVIDUALS