Request a HearingUnemployment Insurance Appeals Board 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the last four digits of your Social Security Number (SSN) in the designated field.
3. Print your name clearly in the provided space.
4. Indicate your disagreement with the Notice of Determination(s) by filling in the date and providing a reason if desired.
5. If applicable, explain any delays in notifying about a determination made over 30 days ago.
6. Fill out your last employer’s name and their physical work location, including street address, city, state, and zip code.
7. Provide your work phone number and personal phone number in the specified fields.
8. Indicate if you would like your hearing conducted in a language other than English and specify which language if applicable.
9. List any dates you are unavailable for a hearing.
10. Complete your email and mailing address details, ensuring all information is accurate.
11. Finally, sign and date the form before submitting it through our platform for free.

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