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DES Constituent Form
Legislative Submission form to DES
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Your Senator Name
*
Choose
Dan Blue
Jay J. Chaudhuri
Ben Clark
Sarah Crawford
Don Davis
Kirk deViere
Milton F. "Toby" Fitch, Jr.
Valerie P. Foushee
Michael Garrett
Jeff Jackson
Paul A. Lowe, Jr.
Natasha R. Marcus
Julie Mayfield
Mujtaba A. Mohammed
Natalie Murdock
Wiley Nickel
Gladys A. Robinson
Deandrea Salvador
Sam Searcy
Ernestine Bazemore
Joyce Waddell
Mike Woodard
UNKNOWN
First & Last Name
*
Your answer
Claimant Number (Provided to you by DES)
Your answer
Street Address
*
Your answer
City/Town
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Which defines your issue?
*
Claim is NOT filed - Not tried to file an unemployment claim or contacted DES
Claim is NOT filed - Unable to get through by phone or online
Claim IS filed - Error on claim need to fix
Claim IS filed - Need Status
Claim IS filed - Claim was denied
Unemployment Benefit Programs
Unemployment Benefit Timelines
Type of Claim filed
State Unemployment Insurance
PUA - Pandemic Unemployment Assistance
PEUC - Pandemic Emergency Unemployment Compensation
FPUC - Federal Pandemic Unemployment Compensation
MEUC - Mixed Earner Unemployment Compensation
Other:
Date Filed Claim
MM
/
DD
/
YYYY
Briefly describe assistance needed
Your answer
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