Michigan Laborers Unemployment Assistance Form

Complete this form if and only if you are having difficulties with the Michigan Unemployment Insurance Agency (UIA) processing your unemployment claim. A member of the Laborers District Council will be in touch about your claim within a few business days.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

the email that is associated with the Unemployment claim that you submitted

Local Number

(ie Laborers Local 355, Local 1191, etc.)

UIA Claim Number

A brief description of your claim and the issues you are having with the Unemployment Insurance Agency (UIA).

Any additional information you can provide that you believe would be valuable for the Laborers District Council to know that may be of use in assisting you in your claim. If you have nothing to add, please put n/a.

IMPORTANT CHANGE TO THE ADMINISTRATION OF YOUR MICHIGAN LABORERS’ BENEFITS

Michigan Laborers Unemployment Assistance Form