Agency for Workforce Innovation

Benefit Payment Control - Notification of Fraud

 
THIS FORM IS TO REPORT UNEMPLOYMENT COMPENSATION FRAUD ONLY. 
IF YOU WANT TO FILE AN UNEMPLOYMENT COMPENSATION CLAIM 
PLEASE VISIT THE UNEMPLOYMENT COMPENSATION CLAIM  WEBSITE.
 
Please provide the following information, if known.

   
Claimant's Last Four Digits of Social Security Number:
 
Claimant's Name:
 
Name of business where claimant is working:
 
Phone number and contact person where claimant is working:
 
Job Site Address:
 
Dates Worked:
 
Type of Work Performed:
 
Additional Information:
   
 

An equal opportunity employer/program.  Auxiliary aids and services are available upon request to individuals with disabilities.  All voice telephone numbers on this website may be reached by persons using TTY/TDD equipment via the Florida Relay Service at 711.

Programa/Empresa que ofrece igualdad de oportunidades. Los asistentes y servicios auxiliares están disponibles a pedido de personas con incapacidades. Aquellas personas que usen equipos TTY/TTD a través del Servicio de Retransmisión de Florida llamando al 711 pueden acceder a todos los números telefónicos de voz en este sitio Web.