Uc 217 2026

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The document UC-217 is a form used to collect retirement income information for individuals applying for benefits through the Connecticut Department of Labor. It requires specific personal details such as Social Security Number, name, date of birth, and contact information, along with pension-related data including type, gross monthly amount, payment dates, and employer financing details. The form must be completed and submitted to the Shared Work Unit.

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Click ‘Get Form’ to open the UC-217 in the editor.
Begin by filling in your *Social Security Number*, *Name*, and *Date of Birth* in the designated fields. These are essential for identification.
Next, provide your *Telephone Number* and any relevant job center information. This helps streamline communication.
For the retirement income section, specify your *Pension Type* and enter the *Gross Monthly Amount*. Ensure accuracy as this affects your benefits.
Indicate the *Date 1st Payment Rec’d* and whether it is *Employer Financed*. This information is crucial for processing your claim.
If applicable, fill out details regarding any lump sum amounts received, including dates and financing sources.
Complete the employer or union section by providing their name, address, and dates worked. This ensures proper verification of employment history.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (66 Votes)
2005	4.3 Satisfied (52 Votes)

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Uc 217 2026

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