Comments, Suggestions, and or Complaints DE 8123 Rev 8 (10-21)-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out your Contact Information. Enter your Name, Address, Phone Number, Alternate Number, Email Address, and Preferred Language in the designated fields.
3. Next, provide Incident Information by entering the Date of Incident and Location/Address where the incident occurred.
4. In the Service Area section, check all applicable services that relate to your comments or complaints such as Unemployment Insurance or Disability Insurance.
5. If you have a Language Access Issue, check all relevant boxes indicating your concerns regarding bilingual personnel or materials.
6. Use the provided space to enter your comment, complaint, or suggestion. If more space is needed, feel free to attach an additional sheet.
7. Indicate whether you would like a response by checking 'Yes' or 'No'.
8. Once completed, save your document and follow the instructions for mailing it to the appropriate address listed on the form.

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