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Joan Ballweg, Wisconsin State Senator, District 14
Services
Unemployment Case Intake Form
Unemployment Case Intake Form
Full Name
*
Please enter your First and Last Name
Address
*
Please enter your address, including city and zip code.
Phone Number
*
Please enter the phone number linked to your unemployment case
Email Address
*
Please enter your email address
DOB
*
Please enter your date of birth MM/DD/YYYY
Last Four Digits of SSN
*
Please enter the last four digits of your social security number
Status and Details of Case
*
Please enter all relevant information regarding your case. If you would like to forward any relevant documents relating to your case, please email them to Sen.Ballweg@legis.wisconsin.gov
Time Waiting Since Applying
*
Please enter how long you have been waiting.
Is your case PUA, or is it UI?
*
Please enter one
